MUE

Code Code Description CPT Code CPT Code CPT
Effective Expiry MUE Values

Date Date
0026T Lipoprotein, direct measurement, intermediate density lipoproteins (IDL) 30-Sep-08 14-Oct-12
(remnant lipoproteins)
0027T Endoscopic lysis of epidural adhesions with direct visualization using mechanical 30-Sep-08 14-Oct-12
means (eg, spinal endoscopic catheter system) or solution injection (eg, normal
saline) including radiologic localization and epidurography
0028T Dual energy x-ray absorptiometry (DEXA) body composition study, one or more 30-Sep-08 14-Oct-12
sites
0029T Treatment(s) for incontinence, pulsed magnetic neuromodulation, per day 30-Sep-08 14-Oct-12
0030T Antiprothrombin (phospholipid cofactor) antibody, each Ig class 30-Sep-08 2

0031T Speculoscopy; 30-Sep-08 14-Oct-12
0032T Speculoscopy; with directed sampling 30-Sep-08 14-Oct-12
0041T Urinalysis infectious agent detection, semi-quantitative analysis of volatile 30-Sep-08 14-Oct-12
compounds
0042T Cerebral perfusion analysis using computed tomography with contrast 30-Sep-08 1
administration, including post-processing of parametric maps with determination
of cerebral blood flow, cerebral blood volume, and mean transit time
0043T Carbon monoxide, expired gas analysis (eg, ETCOc/hemolysis breath test) 30-Sep-08 14-Oct-12
0046T Catheter lavage of a mammary duct(s) for collection of cytology specimen(s), in 30-Sep-08 14-Oct-12
high risk individuals (GAIL risk scoring or prior personal history of breast cancer),
each breast; single duct
0047T Catheter lavage of a mammary duct(s) for collection of cytology specimen(s), in 30-Sep-08 14-Oct-12
high risk individuals (GAIL risk scoring or prior personal history of breast cancer),
each breast; each additional duct
0048T Implantation of a ventricular assist device, extracorporeal, percutaneous 30-Sep-08 1
transseptal access, single or dual cannulation
0049T Prolonged extracorporeal percutaneous transseptal ventricular assist device, 30-Sep-08 14-Oct-12
greater than 24 hours, each subsequent 24 hour period (List separately in
addition to code for primary procedure)
0050T Removal of a ventricular assist device, extracorporeal, percutaneous transseptal 30-Sep-08 1
access, single or dual cannulation
0051T Implantation of a total replacement heart system (artificial heart) with recipient 30-Sep-08 1
cardiectomy
0052T Replacement or repair of thoracic unit of a total replacement heart system 30-Sep-08 1
(artificial heart)
0053T Replacement or repair of implantable component or components of total 30-Sep-08 1
replacement heart system (artificial heart), excluding thoracic unit
0054T Computer-assisted musculoskeletal surgical navigational orthopedic procedure, 15-Oct-12 2

with image-guidance based on fluoroscopic images (List separately in addition to
code for primary procedure)
0055T Computer-assisted musculoskeletal surgical navigational orthopedic procedure, 15-Oct-12 2
with image-guidance based on CT/MRI images (List separately in addition to
0058T Cryopreservation; reproductive tissue, ovarian 30-Sep-08
0059T Cryopreservation; oocyte(s) 30-Sep-08
0060T Electrical impedance scan of the breast, bilateral (risk assessment device for 30-Sep-08 14-Oct-12
breast cancer)
0061T Destruction/reduction of malignant breast tumor including breast carcinoma cells 30-Sep-08 14-Oct-12
in the margins, microwave phased array thermotherapy, disposable catheter
with combined temperature monitoring probe and microwave sensor, externally
applied microwave energy
0062T Percutaneous intradiscal annuloplasty, any method except electrothermal, 30-Sep-08 14-Oct-12
unilateral or bilateral including fluoroscopic guidance; single level
0063T Percutaneous intradiscal annuloplasty, any method except electrothermal, 30-Sep-08 14-Oct-12
unilateral or bilateral including fluoroscopic guidance; 1 or more additional levels
(List separately in addition to 0062T for primary procedure)
0064T Spectroscopy, expired gas analysis (eg, nitric oxide/carbon dioxide test) 30-Sep-08 14-Oct-12
0066T Computed tomographic (CT) colonography (ie, virtual colonoscopy); screening 30-Sep-08 14-Oct-12
0067T Computed tomographic (CT) colonography (ie, virtual colonoscopy); diagnostic 30-Sep-08 14-Oct-12
0068T Acoustic heart sound recording and computer analysis; with interpretation and 30-Sep-08 14-Oct-12
report
0069T Acoustic heart sound recording and computer analysis; acoustic heart sound 30-Sep-08 14-Oct-12
recording and computer analysis only
0070T Acoustic heart sound recording and computer analysis; interpretation and report 30-Sep-08 14-Oct-12
only
0071T Focused ultrasound ablation of uterine leiomyomata, including MR guidance; 30-Sep-08 1
total leiomyomata volume less than 200 cc of tissue
0072T Focused ultrasound ablation of uterine leiomyomata, including MR guidance; 30-Sep-08 1
total leiomyomata volume greater or equal to 200 cc of tissue
0073T Compensator-based beam modulation treatment delivery of inverse planned 30-Sep-08 2

treatment using 3 or more high resolution (milled or cast) compensator
convergent beam modulated fields, per treatment session
0075T Transcatheter placement of extracranial vertebral or intrathoracic carotid artery 30-Sep-08 1

stent(s), including radiologic supervision and interpretation, percutaneous; initial
vessel
0076T Transcatheter placement of extracranial vertebral or intrathoracic carotid artery 30-Sep-08 2
stent(s), including radiologic supervision and interpretation, percutaneous; each
additional vessel (List separately in addition to code for primary procedure)
0077T Implanting and securing cerebral thermal perfusion probe, including twist drill or 30-Sep-08 14-Oct-12
burr hole, to measure absolute cerebral tissue perfusion
0078T Endovascular repair using prosthesis of abdominal aortic aneurysm, 30-Sep-08 1
pseudoaneurysm or dissection, abdominal aorta involving visceral branches
(superior mesenteric, celiac and/or renal artery[s])
0079T Placement of visceral extension prosthesis for endovascular repair of abdominal 30-Sep-08 4
aortic aneurysm involving visceral vessels, each visceral branch (List separately
in addition to code for primary procedure)
0080T Endovascular repair of abdominal aortic aneurysm, pseudoaneurysm or 30-Sep-08 1
dissection, abdominal aorta involving visceral vessels (superior mesenteric,
celiac or renal), using fenestrated modular bifurcated prosthesis (2 docking
limbs), radiological supervision and interpretation
0081T Placement of visceral extension prosthesis for endovascular repair of abdominal 30-Sep-08 4
aortic aneurysm involving visceral vessels, each visceral branch, radiological
supervision and interpretation (List separately in addition to code for primary
procedure)
0084T Insertion of a temporary prostatic urethral stent 30-Sep-08 14-Oct-12
0085T Breath test for heart transplant rejection 30-Sep-08
0086T Left ventricular filling pressure indirect measurement by computerized 30-Sep-08 14-Oct-12
calibration of the arterial waveform response to Valsalva maneuver
0087T Sperm evaluation, Hyaluronan sperm binding test 30-Sep-08 14-Oct-12

0088T Submucosal radiofrequency tissue volume reduction of tongue base, one or 30-Sep-08 14-Oct-12
more sites, per session (ie, for treatment of obstructive sleep apnea syndrome)
0089T Actigraphy testing, recording, analysis and interpretation (minimum of three-day 30-Sep-08 14-Oct-12
recording)
0090T Total disc arthroplasty (artificial disc), anterior approach, including discectomy to 30-Sep-08 14-Oct-12
prepare interspace (other than for decompression) cervical; single interspace
0092T Total disc arthroplasty (artificial disc), anterior approach, including discectomy 30-Sep-08 1
with end plate preparation (includes osteophytectomy for nerve root or spinal
cord decompression and microdissection), each additional interspace, cervical
(List separately in addition to code for primary procedure)
0093T Removal of total disc arthroplasty, anterior approach cervical; single interspace 30-Sep-08 14-Oct-12
0095T Removal of total disc arthroplasty (artificial disc), anterior approach, each 30-Sep-08 1
additional interspace, cervical (List separately in addition to code for primary
procedure)
0096T Revision of total disc arthroplasty, anterior approach cervical; single interspace 30-Sep-08 14-Oct-12
0098T Revision including replacement of total disc arthroplasty (artificial disc), anterior 30-Sep-08 1
approach, each additional interspace, cervical (List separately in addition to
0099T Implantation of intrastromal corneal ring segments 30-Sep-08 2
0100T Placement of a subconjunctival retinal prosthesis receiver and pulse generator, 30-Sep-08 2
and implantation of intra-ocular retinal electrode array, with vitrectomy
0101T Extracorporeal shock wave involving musculoskeletal system, not otherwise 30-Sep-08 1
specified, high energy
0102T Extracorporeal shock wave, high energy, performed by a physician, requiring 30-Sep-08 2
anesthesia other than local, involving lateral humeral epicondyle
0103T Holotranscobalamin, quantitative 30-Sep-08 1

0104T Inert gas rebreathing for cardiac output measurement; during rest 30-Sep-08 14-Oct-12
0105T Inert gas rebreathing for cardiac output measurement; during exercise 30-Sep-08 14-Oct-12
0106T Quantitative sensory testing (QST), testing and interpretation per extremity; 30-Sep-08 4
using touch pressure stimuli to assess large diameter sensation
using vibration stimuli to assess large diameter fiber sensation
using cooling stimuli to assess small nerve fiber sensation and hyperalgesia
using heat-pain stimuli to assess small nerve fiber sensation and hyperalgesia
using other stimuli to assess sensation
01112 Anesthesia for bone marrow aspiration and/or biopsy, anterior or posterior iliac 1-Aug-10
crest
0111T Long-chain (C20-22) omega-3 fatty acids in red blood cell (RBC) membranes 30-Sep-08 1
0123T Fistulization of sclera for glaucoma, through ciliary body 30-Sep-08 2

0124T Conjunctival incision with posterior extrascleral placement of pharmacological 30-Sep-08 2
agent (does not include supply of medication)
0126T Common carotid intima-media thickness (IMT) study for evaluation of 30-Sep-08 1
atherosclerotic burden or coronary heart disease risk factor assessment
0130T Validated, statistically reliable, randomized, controlled, single-patient clinical 30-Sep-08 14-Oct-12
investigation of FDA approved chronic care drugs, provided by a pharmacist,
interpretation and report to the prescribing health care professional
0137T Biopsy, prostate, needle, saturation sampling for prostate mapping 30-Sep-08 14-Oct-12
0140T Exhaled breath condensate pH 30-Sep-08 14-Oct-12
0141T Pancreatic islet cell transplantation through portal vein, percutaneous 30-Sep-08
0142T Pancreatic islet cell transplantation through portal vein, open 30-Sep-08
0143T Laparoscopy, surgical, pancreatic islet cell transplantation through portal vein 30-Sep-08
0144T Computed tomography, heart, without contrast material, including image 30-Sep-08 14-Oct-12
postprocessing and quantitative evaluation of coronary calcium
0145T Computed tomography, heart, with contrast material(s), including noncontrast 30-Sep-08 14-Oct-12
images, if performed, cardiac gating and 3D image postprocessing; cardiac
structure and morphology
images, if performed, cardiac gating and 3D image postprocessing; computed
tomographic angiography of coronary arteries (including native and anomalous
coronary arteries, coronar
images, if performed, cardiac gating and 3D image postprocessing; computed
tomographic angiography of coronary arteries (including native and anomalous
coronary arteries, coronar
structure and morphology and computed tomographic angiography of coronary
arteries (including native and
structure and morphology and computed tomographic angiography of coronary
arteries (including native and
structure and morphology in congenital heart disease
images, if performed, cardiac gating and 3D image postprocessing, function
evaluation (left and right ventricular function, ejection-fraction and segmental
wall motion) (List sep
0155T Laparoscopy, surgical; implantation or replacement of gastric stimulation 30-Sep-08
electrodes, lesser curvature (ie, morbid obesity)
0156T Laparoscopy, surgical; revision or removal of gastric stimulation electrodes, 30-Sep-08
lesser curvature (ie, morbid obesity)
0157T Laparotomy, implantation or replacement of gastric stimulation electrodes, 30-Sep-08
lesser curvature (ie, morbid obesity)
0158T Laparotomy, revision or removal of gastric stimulation electrodes, lesser 30-Sep-08
curvature (ie, morbid obesity)
0159T Computer-aided detection, including computer algorithm analysis of MRI image 30-Sep-08 2
data for lesion detection/characterization, pharmacokinetic analysis, with further
physician review for interpretation, breast MRI (List separately in addition to
0160T Therapeutic repetitive transcranial magnetic stimulation treatment planning 30-Sep-08 14-Oct-12
0161T Therapeutic repetitive transcranial magnetic stimulation treatment delivery and 30-Sep-08 14-Oct-12
management, per session
0162T Electronic analysis and programming, reprogramming of gastric neurostimulator 30-Sep-08 14-Oct-12
(ie, morbid obesity)
0163T Total disc arthroplasty (artificial disc), anterior approach, including discectomy to 30-Sep-08 2
prepare interspace (other than for decompression), each additional interspace,
lumbar (List separately in addition to code for primary procedure)
0164T Removal of total disc arthroplasty, (artificial disc), anterior approach, each 30-Sep-08 4
additional interspace, lumbar (List separately in addition to code for primary
procedure)
0165T Revision including replacement of total disc arthroplasty (artificial disc), anterior 30-Sep-08 4
approach, each additional interspace, lumbar (List separately in addition to code
for primary procedure)
0166T Transmyocardial transcatheter closure of ventricular septal defect, with implant; 30-Sep-08
without cardiopulmonary bypass
0167T Transmyocardial transcatheter closure of ventricular septal defect, with implant; 30-Sep-08
with cardiopulmonary bypass
0168T Rhinophototherapy, intranasal application of ultraviolet and visible light, bilateral 30-Sep-08
0169T Stereotactic placement of infusion catheter(s) in the brain for delivery of 30-Sep-08 1
therapeutic agent(s), including computerized stereotactic planning and burr
hole(s)
0170T Repair of anorectal fistula with plug (eg, porcine small intestine submucosa 30-Sep-08 14-Oct-12
[SIS])
0171T Insertion of posterior spinous process distraction device (including necessary 30-Sep-08 1
removal of bone or ligament for insertion and imaging guidance), lumbar; single
level
0172T Insertion of posterior spinous process distraction device (including necessary 30-Sep-08 3
removal of bone or ligament for insertion and imaging guidance), lumbar; each
additional level (List separately in addition to code for primary procedure)
0173T Monitoring of intraocular pressure during vitrectomy surgery (List separately in 30-Sep-08 1
0174T Computer-aided detection (CAD) (computer algorithm analysis of digital image 30-Sep-08 1
data for lesion detection) with further physician review for interpretation and
report, with or without digitization of film radiographic images, chest
radiograph(s), performed concurrent with primary interpretation (List separately
0175T Computer-aided detection (CAD) (computer algorithm analysis of digital image 30-Sep-08 1
data for lesion detection) with further physician review for interpretation and
report, with or without digitization of film radiographic images, chest
radiograph(s), performed remote from primary interpretation
0176T Transluminal dilation of aqueous outflow canal; without retention of device or 30-Sep-08 14-Oct-12
stent
0177T Transluminal dilation of aqueous outflow canal; with retention of device or stent 30-Sep-08 14-Oct-12
0178T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; 30-Sep-08
with interpretation and report
0179T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; 30-Sep-08 1
tracing and graphics only, without interpretation and report
0180T Electrocardiogram, 64 leads or greater, with graphic presentation and analysis; 30-Sep-08 1
interpretation and report only
0181T Corneal hysteresis determination, by air impulse stimulation, bilateral, with 30-Sep-08 1
interpretation and report
0182T High dose rate electronic brachytherapy, per fraction 30-Sep-08 3
0183T Low frequency, non-contact, non-thermal ultrasound, including topical 30-Sep-08 1
application(s), when performed, wound assessment, and instruction(s) for
ongoing care, per day
0184T Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, 15-Oct-12 1
TEMS), including muscularis propria (ie, full thickness)
0185T Multivariate analysis of patient-specific findings with quantifiable computer 15-Oct-12
probability assessment, including report
0186T Suprachoroidal delivery of pharmacologic agent (does not include supply of 15-Oct-12
medication)
0188T Remote real-time interactive video-conferenced critical care, evaluation and 15-Oct-12
management of the critically ill or critically injured patient; first 30-74 minutes
0189T Remote real-time interactive video-conferenced critical care, evaluation and 15-Oct-12
management of the critically ill or critically injured patient; each additional 30
minutes (List separately in addition to code for primary service)
0190T Placement of intraocular radiation source applicator (List separately in addition 15-Oct-12 2
to primary procedure)
0191T Insertion of anterior segment aqueous drainage device, without extraocular 15-Oct-12 2
reservoir; internal approach, into the trabecular meshwork
reservoir; external approach
0195T Arthrodesis, pre-sacral interbody technique, including instrumentation, imaging 15-Oct-12
(when performed), and discectomy to prepare interspace, lumbar; single
interspace
0196T Arthrodesis, pre-sacral interbody technique, including instrumentation, imaging 15-Oct-12
(when performed), and discectomy to prepare interspace, lumbar; each
additional interspace (List separately in addition to code for primary procedure)
0197T Intra-fraction localization and tracking of target or patient motion during delivery 15-Oct-12 2
of radiation therapy (eg, 3D positional tracking, gating, 3D surface tracking),
each fraction of treatment
0198T Measurement of ocular blood flow by repetitive intraocular pressure sampling, 15-Oct-12 2
0199T Physiologic recording of tremor using accelerometer(s) and/or gyroscope(s) 15-Oct-12
(including frequency and amplitude), including interpretation and report
0200T Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including 15-Oct-12

the use of a balloon or mechanical device, when used, 1 or more needles
0201T Percutaneous sacral augmentation (sacroplasty), bilateral injections, including 15-Oct-12

the use of a balloon or mechanical device, when used, 2 or more needles
0202T Posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including 15-Oct-12
facetectomy, laminectomy, foraminotomy, and vertebral column fixation,
injection of bone cement, when performed, including fluoroscopy, single level,
lumbar spine
0205T Intravascular catheter-based coronary vessel or graft spectroscopy (eg, infrared) 15-Oct-12
during diagnostic evaluation and/or therapeutic intervention including imaging
supervision, interpretation, and report, each vessel (List separately in addition to
0206T Algorithmic analysis, remote, of electrocardiographic-derived data with computer 15-Oct-12

probability assessment, including report
0207T Evacuation of meibomian glands, automated, using heat and intermittent 15-Oct-12
pressure, unilateral
0208T Pure tone audiometry (threshold), automated; air only 15-Oct-12 1
0209T Pure tone audiometry (threshold), automated; air and bone 15-Oct-12 1
0210T Speech audiometry threshold, automated; 15-Oct-12 1
0211T Speech audiometry threshold, automated; with speech recognition 15-Oct-12 1
0212T Comprehensive audiometry threshold evaluation and speech recognition (0209T, 15-Oct-12 1
0211T combined), automated
0213T Injection(s), diagnostic or therapeutic agent, paravertebral facet 15-Oct-12 1
(zygapophyseal) joint (or nerves innervating that joint) with ultrasound
guidance, cervical or thoracic; single level
guidance, cervical or thoracic; second level (List separately in addition to code
guidance, cervical or thoracic; third and any additional level(s) (List separately in
guidance, lumbar or sacral; single level
guidance, lumbar or sacral; second level (List separately in addition to code for
primary procedure)
guidance, lumbar or sacral; third and any additional level(s) (List separately in
0219T Placement of a posterior intrafacet implant(s), unilateral or bilateral, including 15-Oct-12 1
imaging and placement of bone graft(s) or synthetic device(s), single level;
cervical
thoracic
lumbar
0222T Placement of a posterior intrafacet implant(s), unilateral or bilateral, including 15-Oct-12
imaging and placement of bone graft(s) or synthetic device(s), single level; each
additional vertebral segment (List separately in addition to code for primary
procedure)
0223T Acoustic cardiography, including automated analysis of combined acoustic and 15-Oct-12 1
electrical intervals; single, with interpretation and report
electrical intervals; multiple, including serial trended analysis and limited
reprogramming of device parameter, AV or VV delays only, with interpretation
and report
electrical intervals; multiple, including serial trended analysis and limited
reprogramming of device parameter, AV and VV delays, with interpretation and
report
0226T Anoscopy, high resolution (HRA) (with magnification and chemical agent 15-Oct-12 1
enhancement); diagnostic, including collection of specimen(s) by brushing or
washing when performed
0227T Anoscopy, high resolution (HRA) (with magnification and chemical agent 15-Oct-12 1
enhancement); with biopsy(ies)
0228T Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 15-Oct-12 2
ultrasound guidance, cervical or thoracic; single level
0229T Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 15-Oct-12
ultrasound guidance, cervical or thoracic; each additional level (List separately
0230T Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 15-Oct-12 2
ultrasound guidance, lumbar or sacral; single level
0231T Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 15-Oct-12
ultrasound guidance, lumbar or sacral; each additional level (List separately in
0232T Injection(s), platelet rich plasma, any site, including image guidance, harvesting 15-Oct-12 1
and preparation when performed
0233T Skin advanced glycation endproducts (AGE) measurement by multi-wavelength 15-Oct-12 1
fluorescent spectroscopy
0234T Transluminal peripheral atherectomy, open or percutaneous, including 15-Oct-12 2
radiological supervision and interpretation; renal artery
radiological supervision and interpretation; visceral artery (except renal), each
vessel
radiological supervision and interpretation; abdominal aorta

radiological supervision and interpretation; brachiocephalic trunk and branches,
each vessel
0238T Transluminal peripheral atherectomy, open or percutaneous, including 15-Oct-12
radiological supervision and interpretation; iliac artery, each vessel
0239T Bioimpedance spectroscopy (BIS), measuring 100 frequencies or greater, direct 15-Oct-12 1
measurement of extracellular fluid differences between the limbs
0240T Esophageal motility (manometric study of the esophagus and/or 15-Oct-12 1

gastroesophageal junction) study with interpretation and report; with 3-
dimensional high resolution esophageal pressure topography
0241T Esophageal motility (manometric study of the esophagus and/or 15-Oct-12 1
gastroesophageal junction) study with interpretation and report; with stimulation
or perfusion during 3-dimensional high resolution esophageal pressure
topography study, (eg, stimulant, acid or alkali perfusion) (List separately in
0242T Gastrointestinal tract transit and pressure measurement, stomach through colon, 15-Oct-12 1
wireless capsule, with interpretation and report
0243T Intermittent measurement of wheeze rate for bronchodilator or bronchial- 15-Oct-12 1
challenge diagnostic evaluation(s), with interpretation and report
0244T Continuous measurement of wheeze rate during treatment assessment or during 15-Oct-12 1
sleep for documentation of nocturnal wheeze and cough for diagnostic
evaluation 3 to 24 hours, with interpretation and report
0245T Open treatment of rib fracture requiring internal fixation, unilateral; 1-2 ribs 15-Oct-12 1
0248T Open treatment of rib fracture requiring internal fixation, unilateral; 7 or more 15-Oct-12 1
ribs
0249T Ligation, hemorrhoidal vascular bundle(s), including ultrasound guidance 15-Oct-12 1
0250T Airway sizing and insertion of bronchial valve(s), each lobe (List separately in 15-Oct-12 2
0251T Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 15-Oct-12 1
performed; with removal of bronchial valve(s), initial lobe
0252T Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 15-Oct-12 2
performed; with removal of bronchial valve(s), each additional lobe (List
separately in addition to code for primary procedure)
reservoir; internal approach, into the suprachoroidal space
0254T Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, 15-Oct-12 2
arteriovenous malformation, trauma) using bifurcated endoprosthesis from the
common iliac artery into both the external and internal iliac artery, unilateral;
0255T Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, 15-Oct-12 2
arteriovenous malformation, trauma) using bifurcated endoprosthesis from the
common iliac artery into both the external and internal iliac artery, unilateral;
radiological supervision and interpretation
0256T Implantation of catheter-delivered prosthetic aortic heart valve; endovascular 15-Oct-12 1

approach
0257T Implantation of catheter-delivered prosthetic aortic heart valve; open thoracic 15-Oct-12 1
approach (eg, transapical, transventricular)
0258T Transthoracic cardiac exposure (eg, sternotomy, thoracotomy, subxiphoid) for 15-Oct-12 1
catheter-delivered aortic valve replacement; without cardiopulmonary bypass
0259T Transthoracic cardiac exposure (eg, sternotomy, thoracotomy, subxiphoid) for 15-Oct-12 1
catheter-delivered aortic valve replacement; with cardiopulmonary bypass
10021 Fine needle aspiration; without imaging guidance 30-Sep-08

10022 Fine needle aspiration; with imaging guidance 30-Sep-08
10040 Acne surgery (eg, marsupialization, opening or removal of multiple milia, 30-Sep-08 1
comedones, cysts, pustules)
10060 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, 30-Sep-08 1
cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); simple or
single
10061 Incision and drainage of abscess (eg, carbuncle, suppurative hidradenitis, 30-Sep-08 1
cutaneous or subcutaneous abscess, cyst, furuncle, or paronychia); complicated
or multiple
10080 Incision and drainage of pilonidal cyst; simple 30-Sep-08 1
10081 Incision and drainage of pilonidal cyst; complicated 30-Sep-08 1
10120 Incision and removal of foreign body, subcutaneous tissues; simple 30-Sep-08
10121 Incision and removal of foreign body, subcutaneous tissues; complicated 30-Sep-08
10140 Incision and drainage of hematoma, seroma or fluid collection 30-Sep-08

10160 Puncture aspiration of abscess, hematoma, bulla, or cyst 30-Sep-08
10180 Incision and drainage, complex, postoperative wound infection 30-Sep-08 3
11000 Debridement of extensive eczematous or infected skin; up to 10% of body 30-Sep-08 1
surface
11001 Debridement of extensive eczematous or infected skin; each additional 10% of 30-Sep-08
the body surface, or part thereof (List separately in addition to code for primary
procedure)
11004 Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft 30-Sep-08 1
tissue infection; external genitalia and perineum
tissue infection; abdominal wall, with or without fascial closure
tissue infection; external genitalia, perineum and abdominal wall, with or without
fascial closure
11008 Removal of prosthetic material or mesh, abdominal wall for infection (eg, for 30-Sep-08 1
chronic or recurrent mesh infection or necrotizing soft tissue infection) (List
11010 Debridement including removal of foreign material at the site of an open fracture 30-Sep-08
and/or an open dislocation (eg, excisional debridement); skin and subcutaneous
tissues
and/or an open dislocation (eg, excisional debridement); skin, subcutaneous
tissue, muscle fascia, and muscle
and/or an open dislocation (eg, excisional debridement); skin, subcutaneous
tissue, muscle fascia, muscle, and bone
11040 Debridement; skin, partial thickness 30-Sep-08 14-Oct-12

11041 Debridement; skin, full thickness 30-Sep-08 14-Oct-12
11042 Debridement, subcutaneous tissue (includes epidermis and dermis, if 30-Sep-08 1
performed); first 20 sq cm or less
11043 Debridement, muscle and/or fascia (includes epidermis, dermis, and 30-Sep-08 1
subcutaneous tissue, if performed); first 20 sq cm or less
11044 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle 30-Sep-08 1
and/or fascia, if performed); first 20 sq cm or less
11045 Debridement, subcutaneous tissue (includes epidermis and dermis, if 15-Oct-12
performed); each additional 20 sq cm, or part thereof (List separately in addition
to code for primary procedure)
11046 Debridement, muscle and/or fascia (includes epidermis, dermis, and 15-Oct-12
subcutaneous tissue, if performed); each additional 20 sq cm, or part thereof
11047 Debridement, bone (includes epidermis, dermis, subcutaneous tissue, muscle 15-Oct-12
and/or fascia, if performed); each additional 20 sq cm, or part thereof (List
11055 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion 30-Sep-08 1
11056 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); 2 to 4 30-Sep-08 1
lesions
11057 Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than 4 30-Sep-08 1
lesions
11100 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple 30-Sep-08 1
closure), unless otherwise listed; single lesion
11101 Biopsy of skin, subcutaneous tissue and/or mucous membrane (including simple 30-Sep-08
closure), unless otherwise listed; each separate/additional lesion (List separately
11200 Removal of skin tags, multiple fibrocutaneous tags, any area; up to and including 30-Sep-08 1
15 lesions
11201 Removal of skin tags, multiple fibrocutaneous tags, any area; each additional 10 30-Sep-08 1
lesions, or part thereof (List separately in addition to code for primary
procedure)
11300 Shaving of epidermal or dermal lesion, single lesion, trunk, arms or legs; lesion 30-Sep-08
diameter 0.5 cm or less
diameter 0.6 to 1.0 cm
diameter over 2.0 cm
11305 Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, 30-Sep-08
genitalia; lesion diameter 0.5 cm or less
genitalia; lesion diameter 0.6 to 1.0 cm
genitalia; lesion diameter 1.1 to 2.0 cm
genitalia; lesion diameter over 2.0 cm
11310 Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, 30-Sep-08
lips, mucous membrane; lesion diameter 0.5 cm or less
lips, mucous membrane; lesion diameter 0.6 to 1.0 cm
lips, mucous membrane; lesion diameter 1.1 to 2.0 cm
lips, mucous membrane; lesion diameter over 2.0 cm
11400 Excision, benign lesion including margins, except skin tag (unless listed 30-Sep-08
elsewhere), trunk, arms or legs; excised diameter 0.5 cm or less
elsewhere), trunk, arms or legs; excised diameter 0.6 to 1.0 cm
elsewhere), trunk, arms or legs; excised diameter over 4.0 cm
elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less
elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm
elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm
11440 Excision, other benign lesion including margins, except skin tag (unless listed 30-Sep-08
elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter
0.5 cm or less
0.6 to 1.0 cm
1.1 to 2.0 cm
2.1 to 3.0 cm
3.1 to 4.0 cm
11446 Excision, other benign lesion including margins, except skin tag (unless listed 30-Sep-08 3
over 4.0 cm
11450 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or 30-Sep-08 2
intermediate repair
11451 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex 30-Sep-08 2
repair
11462 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or 30-Sep-08 2
intermediate repair
11463 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex 30-Sep-08 2
repair
11470 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or 30-Sep-08
umbilical; with simple or intermediate repair
11471 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or 30-Sep-08 2
umbilical; with complex repair
11600 Excision, malignant lesion including margins, trunk, arms, or legs; excised 30-Sep-08
11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; 30-Sep-08
excised diameter 0.5 cm or less
excised diameter 0.6 to 1.0 cm
excised diameter over 4.0 cm
11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 30-Sep-08
excised diameter 0.5 cm or less
11646 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; 30-Sep-08 3
excised diameter over 4.0 cm
11719 Trimming of nondystrophic nails, any number 30-Sep-08 1
11720 Debridement of nail(s) by any method(s); 1 to 5 30-Sep-08 1
11721 Debridement of nail(s) by any method(s); 6 or more 30-Sep-08 1
11730 Avulsion of nail plate, partial or complete, simple; single 30-Sep-08 1
11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate (List 30-Sep-08
11740 Evacuation of subungual hematoma 30-Sep-08
11750 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed 30-Sep-08
nail), for permanent removal;
11752 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed 30-Sep-08
nail), for permanent removal; with amputation of tuft of distal phalanx
11755 Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail 30-Sep-08
folds) (separate procedure)
11760 Repair of nail bed 30-Sep-08
11762 Reconstruction of nail bed with graft 30-Sep-08
11765 Wedge excision of skin of nail fold (eg, for ingrown toenail) 30-Sep-08
11770 Excision of pilonidal cyst or sinus; simple 30-Sep-08 1
11771 Excision of pilonidal cyst or sinus; extensive 30-Sep-08 1
11772 Excision of pilonidal cyst or sinus; complicated 30-Sep-08 1
11900 Injection, intralesional; up to and including 7 lesions 30-Sep-08 1
11901 Injection, intralesional; more than 7 lesions 30-Sep-08 1
11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color 30-Sep-08 1
defects of skin, including micropigmentation; 6.0 sq cm or less
defects of skin, including micropigmentation; 6.1 to 20.0 sq cm
defects of skin, including micropigmentation; each additional 20.0 sq cm, or part
thereof (List separately in addition to code for primary procedure)
11950 Subcutaneous injection of filling material (eg, collagen); 1 cc or less 30-Sep-08 1
11951 Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc 30-Sep-08 1
11952 Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc 30-Sep-08 1
11954 Subcutaneous injection of filling material (eg, collagen); over 10.0 cc 30-Sep-08 1
11960 Insertion of tissue expander(s) for other than breast, including subsequent 30-Sep-08 3
expansion
11970 Replacement of tissue expander with permanent prosthesis 30-Sep-08 2
11971 Removal of tissue expander(s) without insertion of prosthesis 30-Sep-08 2
11975 Insertion, implantable contraceptive capsules 30-Sep-08
11976 Removal, implantable contraceptive capsules 30-Sep-08 1
11977 Removal with reinsertion, implantable contraceptive capsules 30-Sep-08

11980 Subcutaneous hormone pellet implantation (implantation of estradiol and/or 30-Sep-08 1
testosterone pellets beneath the skin)
11981 Insertion, non-biodegradable drug delivery implant 30-Sep-08 1
11982 Removal, non-biodegradable drug delivery implant 30-Sep-08 1
11983 Removal with reinsertion, non-biodegradable drug delivery implant 30-Sep-08 1
12001 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, 30-Sep-08 1
trunk and/or extremities (including hands and feet); 2.5 cm or less
trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm
trunk and/or extremities (including hands and feet); over 30.0 cm
12011 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or 30-Sep-08 1
mucous membranes; 2.5 cm or less
mucous membranes; 2.6 cm to 5.0 cm
mucous membranes; over 30.0 cm
12020 Treatment of superficial wound dehiscence; simple closure 30-Sep-08 3
12021 Treatment of superficial wound dehiscence; with packing 30-Sep-08 3
12031 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities 30-Sep-08 1
(excluding hands and feet); 2.5 cm or less
(excluding hands and feet); 2.6 cm to 7.5 cm
(excluding hands and feet); over 30.0 cm
12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 30-Sep-08 1
cm or less
cm to 7.5 cm
cm to 12.5 cm
cm to 20.0 cm
cm to 30.0 cm
12047 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30-Sep-08 1
30.0 cm
12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous 30-Sep-08 1
membranes; 2.5 cm or less
membranes; 2.6 cm to 5.0 cm
membranes; over 30.0 cm
13100 Repair, complex, trunk; 1.1 cm to 2.5 cm 30-Sep-08 1
13101 Repair, complex, trunk; 2.6 cm to 7.5 cm 30-Sep-08 1
13102 Repair, complex, trunk; each additional 5 cm or less (List separately in addition 30-Sep-08
13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm 30-Sep-08 1
13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm 30-Sep-08 1
13122 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List 30-Sep-08
13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands 30-Sep-08 1
and/or feet; 1.1 cm to 2.5 cm
13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands 30-Sep-08 1
and/or feet; 2.6 cm to 7.5 cm
13133 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands 30-Sep-08
and/or feet; each additional 5 cm or less (List separately in addition to code for
primary procedure)
13150 Repair, complex, eyelids, nose, ears and/or lips; 1.0 cm or less 30-Sep-08 1
13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm 30-Sep-08 1
13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm 30-Sep-08 1
13153 Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less 30-Sep-08
13160 Secondary closure of surgical wound or dehiscence, extensive or complicated 30-Sep-08 3
14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less 30-Sep-08
14001 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq 30-Sep-08
cm
14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq 30-Sep-08
cm or less
14021 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 30-Sep-08
sq cm to 30.0 sq cm
14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, 30-Sep-08
axillae, genitalia, hands and/or feet; defect 10 sq cm or less
14041 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, 30-Sep-08
axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm
14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 30-Sep-08
10 sq cm or less
14061 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 30-Sep-08
10.1 sq cm to 30.0 sq cm
14300 Adjacent tissue transfer or rearrangement, more than 30 sq cm, unusual or 30-Sep-08 14-Oct-12
complicated, any area
14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 15-Oct-12
sq cm
14302 Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, 15-Oct-12
or part thereof (List separately in addition to code for primary procedure)
14350 Filleted finger or toe flap, including preparation of recipient site 30-Sep-08
15002 Surgical preparation or creation of recipient site by excision of open wounds, 30-Sep-08 1
burn eschar, or scar (including subcutaneous tissues), or incisional release of
scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants
and children
15003 Surgical preparation or creation of recipient site by excision of open wounds, 30-Sep-08
scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or
each additional 1% of body area of infants and children (List separately in
15004 Surgical preparation or creation of recipient site by excision of open wounds, 30-Sep-08 1
scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands,
feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and
children
15005 Surgical preparation or creation of recipient site by excision of open wounds, 30-Sep-08
scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands,
feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each
additional 1% of body area of infants and children (List separately in addition to
15040 Harvest of skin for tissue cultured skin autograft, 100 sq cm or less 30-Sep-08 1
15050 Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal 30-Sep-08 1
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 1% of body 30-Sep-08 1
area of infants and children (except 15050)
15101 Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each 30-Sep-08
additional 1% of body area of infants and children, or part thereof (List
15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body 30-Sep-08 1
area of infants and children
15111 Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each 30-Sep-08
15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, 30-Sep-08 1
hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of
infants and children
15116 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, 30-Sep-08
hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional
1% of body area of infants and children, or part thereof (List separately in
15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08 1
genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of
body area of infants and children (except 15050)
15121 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08
genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each
15130 Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area 30-Sep-08 1
of infants and children
15131 Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each 30-Sep-08
15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, 30-Sep-08 1
hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of
infants and children
15136 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, 30-Sep-08
hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional
1% of body area of infants and children, or part thereof (List separately in
15150 Tissue cultured epidermal autograft, trunk, arms, legs; first 25 sq cm or less 30-Sep-08 1
15151 Tissue cultured epidermal autograft, trunk, arms, legs; additional 1 sq cm to 75 30-Sep-08 1
sq cm (List separately in addition to code for primary procedure)
15152 Tissue cultured epidermal autograft, trunk, arms, legs; each additional 100 sq 30-Sep-08
cm, or each additional 1% of body area of infants and children, or part thereof
15155 Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, 30-Sep-08 1
orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less
15156 Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, 30-Sep-08 1
orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq
cm (List separately in addition to code for primary procedure)
15157 Tissue cultured epidermal autograft, face, scalp, eyelids, mouth, neck, ears, 30-Sep-08
orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm,
or each additional 1% of body area of infants and children, or part thereof (List
15170 Acellular dermal replacement, trunk, arms, legs; first 100 sq cm or less, or 1% of 30-Sep-08 1
body area of infants and children
15171 Acellular dermal replacement, trunk, arms, legs; each additional 100 sq cm, or 30-Sep-08
each additional 1% of body area of infants and children, or part thereof (List
15175 Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08 1
15176 Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08
15200 Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm 30-Sep-08 1
or less
15201 Full thickness graft, free, including direct closure of donor site, trunk; each 30-Sep-08
additional 20 sq cm, or part thereof (List separately in addition to code for
primary procedure)
15220 Full thickness graft, free, including direct closure of donor site, scalp, arms, 30-Sep-08 1
and/or legs; 20 sq cm or less
15221 Full thickness graft, free, including direct closure of donor site, scalp, arms, 30-Sep-08
and/or legs; each additional 20 sq cm, or part thereof (List separately in addition
15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, 30-Sep-08 1
chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less
15241 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, 30-Sep-08
chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq
cm, or part thereof (List separately in addition to code for primary procedure)
15260 Full thickness graft, free, including direct closure of donor site, nose, ears, 30-Sep-08 1
eyelids, and/or lips; 20 sq cm or less
15261 Full thickness graft, free, including direct closure of donor site, nose, ears, 30-Sep-08
eyelids, and/or lips; each additional 20 sq cm, or part thereof (List separately in
15300 Allograft skin for temporary wound closure, trunk, arms, legs; first 100 sq cm or 30-Sep-08 1
less, or 1% of body area of infants and children
15301 Allograft skin for temporary wound closure, trunk, arms, legs; each additional 30-Sep-08
100 sq cm, or each additional 1% of body area of infants and children, or part
15320 Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, 30-Sep-08 1
ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less,
or 1% of body area of infants and children
15321 Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, 30-Sep-08
ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq
15330 Acellular dermal allograft, trunk, arms, legs; first 100 sq cm or less, or 1% of 30-Sep-08 1
15331 Acellular dermal allograft, trunk, arms, legs; each additional 100 sq cm, or each 30-Sep-08
15335 Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08 1
15336 Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, 30-Sep-08
15340 Tissue cultured allogeneic skin substitute; first 25 sq cm or less 30-Sep-08 1

15341 Tissue cultured allogeneic skin substitute; each additional 25 sq cm, or part 30-Sep-08
15360 Tissue cultured allogeneic dermal substitute, trunk, arms, legs; first 100 sq cm or 30-Sep-08 1
less, or 1% of body area of infants and children
15361 Tissue cultured allogeneic dermal substitute, trunk, arms, legs; each additional 30-Sep-08
100 sq cm, or each additional 1% of body area of infants and children, or part
15365 Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, 30-Sep-08 1
ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less,
or 1% of body area of infants and children
15366 Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, 30-Sep-08
ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq
15400 Xenograft, skin (dermal), for temporary wound closure, trunk, arms, legs; first 30-Sep-08 1
100 sq cm or less, or 1% of body area of infants and children
15401 Xenograft, skin (dermal), for temporary wound closure, trunk, arms, legs; each 30-Sep-08
additional 100 sq cm, or each additional 1% of body area of infants and children,
15420 Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, 30-Sep-08 1
mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100
sq cm or less, or 1% of body area of infants and children
15421 Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, 30-Sep-08
mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each
additional 100 sq cm, or each additional 1% of body area of infants and children,
15430 Acellular xenograft implant; first 100 sq cm or less, or 1% of body area of infants 30-Sep-08 1
and children
15431 Acellular xenograft implant; each additional 100 sq cm, or each additional 1% of 30-Sep-08
body area of infants and children, or part thereof (List separately in addition to
15570 Formation of direct or tubed pedicle, with or without transfer; trunk 30-Sep-08 3
15572 Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs 30-Sep-08 2
15574 Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, 30-Sep-08 2
chin, mouth, neck, axillae, genitalia, hands or feet
15576 Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, 30-Sep-08 2
lips, or intraoral
15600 Delay of flap or sectioning of flap (division and inset); at trunk 30-Sep-08 2
15610 Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs 30-Sep-08 2
15620 Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, 30-Sep-08 2
neck, axillae, genitalia, hands, or feet
15630 Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or 30-Sep-08 2
lips
15650 Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), 30-Sep-08 1
any location
15731 Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, 30-Sep-08 1
paramedian forehead flap)
15732 Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, 30-Sep-08
masseter muscle, sternocleidomastoid, levator scapulae)
15734 Muscle, myocutaneous, or fasciocutaneous flap; trunk 30-Sep-08
15736 Muscle, myocutaneous, or fasciocutaneous flap; upper extremity 30-Sep-08
15738 Muscle, myocutaneous, or fasciocutaneous flap; lower extremity 30-Sep-08
15740 Flap; island pedicle 30-Sep-08 3
15750 Flap; neurovascular pedicle 30-Sep-08 2
15756 Free muscle or myocutaneous flap with microvascular anastomosis 30-Sep-08 2
15757 Free skin flap with microvascular anastomosis 30-Sep-08 3
15758 Free fascial flap with microvascular anastomosis 30-Sep-08 3
15760 Graft; composite (eg, full thickness of external ear or nasal ala), including 30-Sep-08 2
primary closure, donor area
15770 Graft; derma-fat-fascia 30-Sep-08 2
15775 Punch graft for hair transplant; 1 to 15 punch grafts 30-Sep-08 1
15776 Punch graft for hair transplant; more than 15 punch grafts 30-Sep-08 1
15780 Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general 30-Sep-08 1
keratosis)
15781 Dermabrasion; segmental, face 30-Sep-08 2
15782 Dermabrasion; regional, other than face 30-Sep-08 2
15783 Dermabrasion; superficial, any site (eg, tattoo removal) 30-Sep-08 2
15786 Abrasion; single lesion (eg, keratosis, scar) 30-Sep-08 1

15787 Abrasion; each additional 4 lesions or less (List separately in addition to code for 30-Sep-08 3
primary procedure)
15788 Chemical peel, facial; epidermal 30-Sep-08 1
15789 Chemical peel, facial; dermal 30-Sep-08 1
15792 Chemical peel, nonfacial; epidermal 30-Sep-08 1
15793 Chemical peel, nonfacial; dermal 30-Sep-08 1
15819 Cervicoplasty 30-Sep-08 1
15820 Blepharoplasty, lower eyelid; 30-Sep-08 1
15821 Blepharoplasty, lower eyelid; with extensive herniated fat pad 30-Sep-08 1
15822 Blepharoplasty, upper eyelid; 30-Sep-08 1
15823 Blepharoplasty, upper eyelid; with excessive skin weighting down lid 30-Sep-08 1
15824 Rhytidectomy; forehead 30-Sep-08 1
15825 Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap) 30-Sep-08 1
15826 Rhytidectomy; glabellar frown lines 30-Sep-08 1
15828 Rhytidectomy; cheek, chin, and neck 30-Sep-08 1
15829 Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap 30-Sep-08 1
15830 Excision, excessive skin and subcutaneous tissue (includes lipectomy); 30-Sep-08 1
abdomen, infraumbilical panniculectomy
15832 Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh 30-Sep-08 2
15833 Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg 30-Sep-08 2
15834 Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip 30-Sep-08 2
15835 Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock 30-Sep-08 1
15836 Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm 30-Sep-08 2
15837 Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm 30-Sep-08
or hand
15838 Excision, excessive skin and subcutaneous tissue (includes lipectomy); 30-Sep-08 1
submental fat pad
15839 Excision, excessive skin and subcutaneous tissue (includes lipectomy); other 30-Sep-08 2
area
15840 Graft for facial nerve paralysis; free fascia graft (including obtaining fascia) 30-Sep-08 1
15841 Graft for facial nerve paralysis; free muscle graft (including obtaining graft) 30-Sep-08 2
15842 Graft for facial nerve paralysis; free muscle flap by microsurgical technique 30-Sep-08 2
15845 Graft for facial nerve paralysis; regional muscle transfer 30-Sep-08 2
15847 Excision, excessive skin and subcutaneous tissue (includes lipectomy), abdomen 30-Sep-08 1
(eg, abdominoplasty) (includes umbilical transposition and fascial plication) (List
15850 Removal of sutures under anesthesia (other than local), same surgeon 30-Sep-08
15851 Removal of sutures under anesthesia (other than local), other surgeon 30-Sep-08 1
15852 Dressing change (for other than burns) under anesthesia (other than local) 30-Sep-08 2
15860 Intravenous injection of agent (eg, fluorescein) to test vascular flow in flap or 30-Sep-08 1
graft
15876 Suction assisted lipectomy; head and neck 30-Sep-08 1
15877 Suction assisted lipectomy; trunk 30-Sep-08 1
15878 Suction assisted lipectomy; upper extremity 30-Sep-08 2
15879 Suction assisted lipectomy; lower extremity 30-Sep-08 2
15920 Excision, coccygeal pressure ulcer, with coccygectomy; with primary suture 30-Sep-08 1
15922 Excision, coccygeal pressure ulcer, with coccygectomy; with flap closure 30-Sep-08 1
15931 Excision, sacral pressure ulcer, with primary suture; 30-Sep-08 1

15933 Excision, sacral pressure ulcer, with primary suture; with ostectomy 30-Sep-08 1
15934 Excision, sacral pressure ulcer, with skin flap closure; 30-Sep-08 1
15935 Excision, sacral pressure ulcer, with skin flap closure; with ostectomy 30-Sep-08 1
15936 Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap 30-Sep-08 1
or skin graft closure;
15937 Excision, sacral pressure ulcer, in preparation for muscle or myocutaneous flap 30-Sep-08 1
or skin graft closure; with ostectomy
15940 Excision, ischial pressure ulcer, with primary suture; 30-Sep-08 2
15941 Excision, ischial pressure ulcer, with primary suture; with ostectomy 30-Sep-08 2
(ischiectomy)
15944 Excision, ischial pressure ulcer, with skin flap closure; 30-Sep-08 2
15945 Excision, ischial pressure ulcer, with skin flap closure; with ostectomy 30-Sep-08 2
15946 Excision, ischial pressure ulcer, with ostectomy, in preparation for muscle or 30-Sep-08 2
myocutaneous flap or skin graft closure
15950 Excision, trochanteric pressure ulcer, with primary suture; 30-Sep-08 2
15951 Excision, trochanteric pressure ulcer, with primary suture; with ostectomy 30-Sep-08 2
15952 Excision, trochanteric pressure ulcer, with skin flap closure; 30-Sep-08 2
15953 Excision, trochanteric pressure ulcer, with skin flap closure; with ostectomy 30-Sep-08 2
15956 Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous 30-Sep-08 2
flap or skin graft closure;
15958 Excision, trochanteric pressure ulcer, in preparation for muscle or myocutaneous 30-Sep-08 2
flap or skin graft closure; with ostectomy
15999 Unlisted procedure, excision pressure ulcer 30-Sep-08
16000 Initial treatment, first degree burn, when no more than local treatment is 30-Sep-08 1
required
16020 Dressings and/or debridement of partial-thickness burns, initial or subsequent; 30-Sep-08 1
small (less than 5% total body surface area)
medium (eg, whole face or whole extremity, or 5% to 10% total body surface
area)
large (eg, more than 1 extremity, or greater than 10% total body surface area)
16035 Escharotomy; initial incision 30-Sep-08 1

16036 Escharotomy; each additional incision (List separately in addition to code for 30-Sep-08
primary procedure)
17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, 30-Sep-08 1
surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion
surgical curettement), premalignant lesions (eg, actinic keratoses); second
through 14 lesions, each (List separately in addition to code for first lesion)

surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more
lesions
17106 Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less 30-Sep-08 1
than 10 sq cm
17107 Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 30-Sep-08 1
10.0 to 50.0 sq cm
17108 Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 30-Sep-08 1
over 50.0 sq cm
surgical curettement), of benign lesions other than skin tags or cutaneous
vascular proliferative lesions; up to 14 lesions
surgical curettement), of benign lesions other than skin tags or cutaneous
vascular proliferative lesions; 15 or more lesions
17250 Chemical cauterization of granulation tissue (proud flesh, sinus or fistula) 30-Sep-08
17260 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, 30-Sep-08
chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.5
cm or less
chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter 0.6 to
1.0 cm
2.0 cm
3.0 cm
17264 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, 30-Sep-08 3
4.0 cm
chemosurgery, surgical curettement), trunk, arms or legs; lesion diameter over
4.0 cm
chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion
chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous
membrane; lesion diameter 0.5 cm or less
membrane; lesion diameter 0.6 to 1.0 cm
membrane; lesion diameter over 4.0 cm
17311 Mohs micrographic technique, including removal of all gross tumor, surgical 30-Sep-08
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; first stage, up to 5
tissue blocks
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; each additional stage
after the first stage, up to 5 tissue blocks (List separately in addition to code for
primary procedure)
including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the
trunk, arms, or legs; first stage, up to 5 tissue blocks
including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), of the
trunk, arms, or legs; each additional stage after the first stage, up to 5 tissue
blocks (List separately in addition to code for primary procedure)
including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), each
additional block after the first 5 tissue blocks, any stage (List separately in
17340 Cryotherapy (CO2 slush, liquid N2) for acne 30-Sep-08 1

17360 Chemical exfoliation for acne (eg, acne paste, acid) 30-Sep-08 1
17380 Electrolysis epilation, each 30 minutes 30-Sep-08 1
17999 Unlisted procedure, skin, mucous membrane and subcutaneous tissue 30-Sep-08
19000 Puncture aspiration of cyst of breast; 30-Sep-08 2

19001 Puncture aspiration of cyst of breast; each additional cyst (List separately in 30-Sep-08 5
19020 Mastotomy with exploration or drainage of abscess, deep 30-Sep-08 2
19030 Injection procedure only for mammary ductogram or galactogram 30-Sep-08 2
19100 Biopsy of breast; percutaneous, needle core, not using imaging guidance 30-Sep-08
(separate procedure)
19101 Biopsy of breast; open, incisional 30-Sep-08 3
19102 Biopsy of breast; percutaneous, needle core, using imaging guidance 30-Sep-08
19103 Biopsy of breast; percutaneous, automated vacuum assisted or rotating biopsy 30-Sep-08
device, using imaging guidance
19105 Ablation, cryosurgical, of fibroadenoma, including ultrasound guidance, each 30-Sep-08
fibroadenoma
19110 Nipple exploration, with or without excision of a solitary lactiferous duct or a 30-Sep-08 2
papilloma lactiferous duct
19112 Excision of lactiferous duct fistula 30-Sep-08 2
19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant 30-Sep-08 2
breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or
female, 1 or more lesions
19125 Excision of breast lesion identified by preoperative placement of radiological 30-Sep-08 2
marker, open; single lesion
19126 Excision of breast lesion identified by preoperative placement of radiological 30-Sep-08 3
marker, open; each additional lesion separately identified by a preoperative
radiological marker (List separately in addition to code for primary procedure)
19260 Excision of chest wall tumor including ribs 30-Sep-08 2

19271 Excision of chest wall tumor involving ribs, with plastic reconstruction; without 30-Sep-08 2
mediastinal lymphadenectomy
19272 Excision of chest wall tumor involving ribs, with plastic reconstruction; with 30-Sep-08 2
mediastinal lymphadenectomy
19290 Preoperative placement of needle localization wire, breast; 30-Sep-08 3
19291 Preoperative placement of needle localization wire, breast; each additional lesion 30-Sep-08
19295 Image guided placement, metallic localization clip, percutaneous, during breast 30-Sep-08
biopsy/aspiration (List separately in addition to code for primary procedure)
19296 Placement of radiotherapy afterloading expandable catheter (single or 30-Sep-08 2

multichannel) into the breast for interstitial radioelement application following
partial mastectomy, includes imaging guidance; on date separate from partial
mastectomy
19297 Placement of radiotherapy afterloading expandable catheter (single or 30-Sep-08 2
multichannel) into the breast for interstitial radioelement application following
partial mastectomy, includes imaging guidance; concurrent with partial
mastectomy (List separately in addition to code for primary procedure)
19298 Placement of radiotherapy afterloading brachytherapy catheters (multiple tube 30-Sep-08 2

and button type) into the breast for interstitial radioelement application
following (at the time of or subsequent to) partial mastectomy, includes imaging
guidance
19300 Mastectomy for gynecomastia 30-Sep-08 2
19301 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, 30-Sep-08 2
segmentectomy);
19302 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, 30-Sep-08 2
segmentectomy); with axillary lymphadenectomy
19303 Mastectomy, simple, complete 30-Sep-08 2
19304 Mastectomy, subcutaneous 30-Sep-08 2
19305 Mastectomy, radical, including pectoral muscles, axillary lymph nodes 30-Sep-08 2
19306 Mastectomy, radical, including pectoral muscles, axillary and internal mammary 30-Sep-08 2
lymph nodes (Urban type operation)
19307 Mastectomy, modified radical, including axillary lymph nodes, with or without 30-Sep-08 2
pectoralis minor muscle, but excluding pectoralis major muscle
19316 Mastopexy 30-Sep-08 1

19318 Reduction mammaplasty 30-Sep-08 1
19324 Mammaplasty, augmentation; without prosthetic implant 30-Sep-08 1
19325 Mammaplasty, augmentation; with prosthetic implant 30-Sep-08 1
19328 Removal of intact mammary implant 30-Sep-08 1

19330 Removal of mammary implant material 30-Sep-08 1
19340 Immediate insertion of breast prosthesis following mastopexy, mastectomy or in 30-Sep-08 1
reconstruction
19342 Delayed insertion of breast prosthesis following mastopexy, mastectomy or in 30-Sep-08 1
reconstruction
19350 Nipple/areola reconstruction 30-Sep-08 1
19355 Correction of inverted nipples 30-Sep-08 1
19357 Breast reconstruction, immediate or delayed, with tissue expander, including 30-Sep-08 1
subsequent expansion
19361 Breast reconstruction with latissimus dorsi flap, without prosthetic implant 30-Sep-08 1
19364 Breast reconstruction with free flap 30-Sep-08 1
19366 Breast reconstruction with other technique 30-Sep-08 1
19367 Breast reconstruction with transverse rectus abdominis myocutaneous flap 30-Sep-08 1
(TRAM), single pedicle, including closure of donor site;
(TRAM), single pedicle, including closure of donor site; with microvascular
anastomosis (supercharging)
(TRAM), double pedicle, including closure of donor site
19370 Open periprosthetic capsulotomy, breast 30-Sep-08 1

19371 Periprosthetic capsulectomy, breast 30-Sep-08 1
19380 Revision of reconstructed breast 30-Sep-08 1
19396 Preparation of moulage for custom breast implant 30-Sep-08 1
19499 Unlisted procedure, breast 30-Sep-08
20000 Incision of soft tissue abscess (eg, secondary to osteomyelitis); superficial 30-Sep-08 14-Oct-12
20005 Incision and drainage of soft tissue abscess, subfascial (ie, involves the soft 30-Sep-08
tissue below the deep fascia)
20100 Exploration of penetrating wound (separate procedure); neck 30-Sep-08 2
20101 Exploration of penetrating wound (separate procedure); chest 30-Sep-08
20102 Exploration of penetrating wound (separate procedure); abdomen/flank/back 30-Sep-08 4
20103 Exploration of penetrating wound (separate procedure); extremity 30-Sep-08 4

20150 Excision of epiphyseal bar, with or without autogenous soft tissue graft obtained 30-Sep-08 2
through same fascial incision
20200 Biopsy, muscle; superficial 30-Sep-08 3
20205 Biopsy, muscle; deep 30-Sep-08 4
20206 Biopsy, muscle, percutaneous needle 30-Sep-08 3
20220 Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, 30-Sep-08
ribs)
20225 Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur) 30-Sep-08
20240 Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, 30-Sep-08
trochanter of femur)
20245 Biopsy, bone, open; deep (eg, humerus, ischium, femur) 30-Sep-08
20250 Biopsy, vertebral body, open; thoracic 30-Sep-08 3
20251 Biopsy, vertebral body, open; lumbar or cervical 30-Sep-08 3
20500 Injection of sinus tract; therapeutic (separate procedure) 30-Sep-08
20501 Injection of sinus tract; diagnostic (sinogram) 30-Sep-08
20520 Removal of foreign body in muscle or tendon sheath; simple 30-Sep-08
20525 Removal of foreign body in muscle or tendon sheath; deep or complicated 30-Sep-08
20526 Injection, therapeutic (eg, local anesthetic, corticosteroid), carpal tunnel 30-Sep-08 2
20550 Injection(s); single tendon sheath, or ligament, aponeurosis (eg, plantar "fascia") 30-Sep-08
20551 Injection(s); single tendon origin/insertion 30-Sep-08

20552 Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s) 30-Sep-08 1
20553 Injection(s); single or multiple trigger point(s), 3 or more muscle(s) 30-Sep-08 1
20555 Placement of needles or catheters into muscle and/or soft tissue for subsequent 30-Sep-08 1
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) 30-Sep-08
20605 Arthrocentesis, aspiration and/or injection; intermediate joint or bursa (eg, 30-Sep-08
temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa)
20610 Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, 30-Sep-08
hip, knee joint, subacromial bursa)
20612 Aspiration and/or injection of ganglion cyst(s) any location 30-Sep-08
20615 Aspiration and injection for treatment of bone cyst 30-Sep-08
20650 Insertion of wire or pin with application of skeletal traction, including removal 30-Sep-08
20660 Application of cranial tongs, caliper, or stereotactic frame, including removal 30-Sep-08 1
20661 Application of halo, including removal; cranial 30-Sep-08 1
20662 Application of halo, including removal; pelvic 30-Sep-08 1
20663 Application of halo, including removal; femoral 30-Sep-08 2
20664 Application of halo, including removal, cranial, 6 or more pins placed, for thin 30-Sep-08 1
skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta)
20665 Removal of tongs or halo applied by another physician 30-Sep-08 1

20670 Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure) 30-Sep-08 2
20680 Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or 30-Sep-08 2
plate)
20690 Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation 30-Sep-08
system
20692 Application of a multiplane (pins or wires in more than 1 plane), unilateral, 30-Sep-08 3
external fixation system (eg, Ilizarov, Monticelli type)
20693 Adjustment or revision of external fixation system requiring anesthesia (eg, new 30-Sep-08 2
pin[s] or wire[s] and/or new ring[s] or bar[s])
20694 Removal, under anesthesia, of external fixation system 30-Sep-08
20696 Application of multiplane (pins or wires in more than 1 plane), unilateral, 15-Oct-12 2
external fixation with stereotactic computer-assisted adjustment (eg, spatial
frame), including imaging; initial and subsequent alignment(s), assessment(s),
and computation(s) of adjustment schedule(s)
20697 Application of multiplane (pins or wires in more than 1 plane), unilateral, 15-Oct-12 4
external fixation with stereotactic computer-assisted adjustment (eg, spatial
frame), including imaging; exchange (ie, removal and replacement) of strut,
each
20802 Replantation, arm (includes surgical neck of humerus through elbow joint), 30-Sep-08 2
complete amputation
20805 Replantation, forearm (includes radius and ulna to radial carpal joint), complete 30-Sep-08 2
amputation
20808 Replantation, hand (includes hand through metacarpophalangeal joints), 30-Sep-08 2
complete amputation
20816 Replantation, digit, excluding thumb (includes metacarpophalangeal joint to 30-Sep-08
insertion of flexor sublimis tendon), complete amputation
20822 Replantation, digit, excluding thumb (includes distal tip to sublimis tendon 30-Sep-08
insertion), complete amputation
20824 Replantation, thumb (includes carpometacarpal joint to MP joint), complete 30-Sep-08 2
amputation
20827 Replantation, thumb (includes distal tip to MP joint), complete amputation 30-Sep-08 2
20838 Replantation, foot, complete amputation 30-Sep-08 2

20900 Bone graft, any donor area; minor or small (eg, dowel or button) 30-Sep-08 2
20902 Bone graft, any donor area; major or large 30-Sep-08
20910 Cartilage graft; costochondral 30-Sep-08 2
20912 Cartilage graft; nasal septum 30-Sep-08 1
20920 Fascia lata graft; by stripper 30-Sep-08 2
20922 Fascia lata graft; by incision and area exposure, complex or sheet 30-Sep-08 2
20924 Tendon graft, from a distance (eg, palmaris, toe extensor, plantaris) 30-Sep-08 4
20926 Tissue grafts, other (eg, paratenon, fat, dermis) 30-Sep-08 2
20930 Allograft, morselized, or placement of osteopromotive material, for spine surgery 30-Sep-08
only (List separately in addition to code for primary procedure)
20931 Allograft, structural, for spine surgery only (List separately in addition to code for 30-Sep-08 1
primary procedure)
20936 Autograft for spine surgery only (includes harvesting the graft); local (eg, ribs, 30-Sep-08
spinous process, or laminar fragments) obtained from same incision (List
20937 Autograft for spine surgery only (includes harvesting the graft); morselized 30-Sep-08 1
(through separate skin or fascial incision) (List separately in addition to code for
primary procedure)
20938 Autograft for spine surgery only (includes harvesting the graft); structural, 30-Sep-08 1
bicortical or tricortical (through separate skin or fascial incision) (List separately
20950 Monitoring of interstitial fluid pressure (includes insertion of device, eg, wick 30-Sep-08
catheter technique, needle manometer technique) in detection of muscle
compartment syndrome
20955 Bone graft with microvascular anastomosis; fibula 30-Sep-08 1
20956 Bone graft with microvascular anastomosis; iliac crest 30-Sep-08 1
20957 Bone graft with microvascular anastomosis; metatarsal 30-Sep-08 1
20962 Bone graft with microvascular anastomosis; other than fibula, iliac crest, or 30-Sep-08 1
metatarsal
20969 Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, 30-Sep-08 2
metatarsal, or great toe
20970 Free osteocutaneous flap with microvascular anastomosis; iliac crest 30-Sep-08 2
20972 Free osteocutaneous flap with microvascular anastomosis; metatarsal 30-Sep-08 2
20973 Free osteocutaneous flap with microvascular anastomosis; great toe with web 30-Sep-08 2
space
20974 Electrical stimulation to aid bone healing; noninvasive (nonoperative) 30-Sep-08 1
20975 Electrical stimulation to aid bone healing; invasive (operative) 30-Sep-08 1
20979 Low intensity ultrasound stimulation to aid bone healing, noninvasive 30-Sep-08 1
(nonoperative)
20982 Ablation, bone tumor(s) (eg, osteoid osteoma, metastasis) radiofrequency, 30-Sep-08 1
percutaneous, including computed tomographic guidance
20985 Computer-assisted surgical navigational procedure for musculoskeletal 30-Sep-08 2

procedures, image-less (List separately in addition to code for primary
procedure)
20986 Computer-assisted surgical navigational procedure for musculoskeletal 30-Sep-08 14-Oct-12
procedures; with image guidance based on intraoperatively obtained images
(eg, fluoroscopy, ultrasound) (List separately in addition to code for primary
procedure)
20987 Computer-assisted surgical navigational procedure for musculoskeletal 30-Sep-08 14-Oct-12
procedures; with image guidance based on preoperative images (List separately
20999 Unlisted procedure, musculoskeletal system, general 30-Sep-08
21010 Arthrotomy, temporomandibular joint 30-Sep-08 1

21011 Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm 15-Oct-12
21012 Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater 15-Oct-12
21013 Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, 15-Oct-12
intramuscular); less than 2 cm
21014 Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, 15-Oct-12
intramuscular); 2 cm or greater
21015 Radical resection of tumor (eg, malignant neoplasm), soft tissue of face or scalp; 30-Sep-08 1
less than 2 cm
21016 Radical resection of tumor (eg, malignant neoplasm), soft tissue of face or scalp; 15-Oct-12
2 cm or greater
21025 Excision of bone (eg, for osteomyelitis or bone abscess); mandible 30-Sep-08 2
21026 Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s) 30-Sep-08 2
21029 Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia) 30-Sep-08 1
21030 Excision of benign tumor or cyst of maxilla or zygoma by enucleation and 30-Sep-08 2
curettage
21031 Excision of torus mandibularis 30-Sep-08 2
21032 Excision of maxillary torus palatinus 30-Sep-08 1
21034 Excision of malignant tumor of maxilla or zygoma 30-Sep-08 1
21040 Excision of benign tumor or cyst of mandible, by enucleation and/or curettage 30-Sep-08 2
21044 Excision of malignant tumor of mandible; 30-Sep-08 1

21045 Excision of malignant tumor of mandible; radical resection 30-Sep-08 1
21046 Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, 30-Sep-08 2
locally aggressive or destructive lesion(s))
21047 Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and 30-Sep-08 2
partial mandibulectomy (eg, locally aggressive or destructive lesion(s))
21048 Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, 30-Sep-08 2
locally aggressive or destructive lesion(s))
21049 Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and 30-Sep-08 2
partial maxillectomy (eg, locally aggressive or destructive lesion(s))
21050 Condylectomy, temporomandibular joint (separate procedure) 30-Sep-08 1

21060 Meniscectomy, partial or complete, temporomandibular joint (separate 30-Sep-08 1
procedure)
21070 Coronoidectomy (separate procedure) 30-Sep-08 1
21073 Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an 30-Sep-08 1
anesthesia service (ie, general or monitored anesthesia care)
21076 Impression and custom preparation; surgical obturator prosthesis 30-Sep-08 1

21077 Impression and custom preparation; orbital prosthesis 30-Sep-08 2
21079 Impression and custom preparation; interim obturator prosthesis 30-Sep-08 1
21080 Impression and custom preparation; definitive obturator prosthesis 30-Sep-08 1
21081 Impression and custom preparation; mandibular resection prosthesis 30-Sep-08 1
21082 Impression and custom preparation; palatal augmentation prosthesis 30-Sep-08 1
21083 Impression and custom preparation; palatal lift prosthesis 30-Sep-08 1
21084 Impression and custom preparation; speech aid prosthesis 30-Sep-08 1
21085 Impression and custom preparation; oral surgical splint 30-Sep-08 1
21086 Impression and custom preparation; auricular prosthesis 30-Sep-08 2
21087 Impression and custom preparation; nasal prosthesis 30-Sep-08 1
21088 Impression and custom preparation; facial prosthesis 30-Sep-08 1
21089 Unlisted maxillofacial prosthetic procedure 30-Sep-08
21100 Application of halo type appliance for maxillofacial fixation, includes removal 30-Sep-08 1
21110 Application of interdental fixation device for conditions other than fracture or 30-Sep-08 2
dislocation, includes removal
21116 Injection procedure for temporomandibular joint arthrography 30-Sep-08 2
21120 Genioplasty; augmentation (autograft, allograft, prosthetic material) 30-Sep-08 1
21121 Genioplasty; sliding osteotomy, single piece 30-Sep-08 1
21122 Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or 30-Sep-08 1
bone wedge reversal for asymmetrical chin)
21123 Genioplasty; sliding, augmentation with interpositional bone grafts (includes 30-Sep-08 1
obtaining autografts)
21125 Augmentation, mandibular body or angle; prosthetic material 30-Sep-08 2
21127 Augmentation, mandibular body or angle; with bone graft, onlay or 30-Sep-08 2
interpositional (includes obtaining autograft)
21137 Reduction forehead; contouring only 30-Sep-08 1
21138 Reduction forehead; contouring and application of prosthetic material or bone 30-Sep-08 1
graft (includes obtaining autograft)
21139 Reduction forehead; contouring and setback of anterior frontal sinus wall 30-Sep-08 1
21141 Reconstruction midface, LeFort I; single piece, segment movement in any 30-Sep-08 1
direction (eg, for Long Face Syndrome), without bone graft
21142 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, 30-Sep-08 1
without bone graft
21143 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any 30-Sep-08 1
direction, without bone graft
21145 Reconstruction midface, LeFort I; single piece, segment movement in any 30-Sep-08 1
direction, requiring bone grafts (includes obtaining autografts)
21146 Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, 30-Sep-08 1
requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral
alveolar cleft)
21147 Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any 30-Sep-08 1
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 30-Sep-08 1
Syndrome)
21151 Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes 30-Sep-08 1
obtaining autografts)
21154 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts 30-Sep-08 1
(includes obtaining autografts); without LeFort I
21155 Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts 30-Sep-08 1
(includes obtaining autografts); with LeFort I
21159 Reconstruction midface, LeFort III (extra and intracranial) with forehead 30-Sep-08 1
advancement (eg, mono bloc), requiring bone grafts (includes obtaining
autografts); without LeFort I
21160 Reconstruction midface, LeFort III (extra and intracranial) with forehead 30-Sep-08 1
advancement (eg, mono bloc), requiring bone grafts (includes obtaining
autografts); with LeFort I
21172 Reconstruction superior-lateral orbital rim and lower forehead, advancement or 30-Sep-08 1
alteration, with or without grafts (includes obtaining autografts)
21175 Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, 30-Sep-08 1
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 30-Sep-08 1
grafts (allograft or prosthetic material)
21180 Reconstruction, entire or majority of forehead and/or supraorbital rims; with 30-Sep-08 1
autograft (includes obtaining grafts)
21181 Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous 30-Sep-08 1
dysplasia), extracranial
21182 Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following 30-Sep-08 2
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
grafting greater than 40 sq cm but less than 80 sq cm
grafting greater than 80 sq cm
21188 Reconstruction midface, osteotomies (other than LeFort type) and bone grafts 30-Sep-08 1
(includes obtaining autografts)
21193 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; 30-Sep-08 1
without bone graft
21194 Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with 30-Sep-08 1
bone graft (includes obtaining graft)
21195 Reconstruction of mandibular rami and/or body, sagittal split; without internal 30-Sep-08 1
rigid fixation
21196 Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid 30-Sep-08 1
fixation
21198 Osteotomy, mandible, segmental; 30-Sep-08 1
21199 Osteotomy, mandible, segmental; with genioglossus advancement 30-Sep-08 1
21206 Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard) 30-Sep-08 1
21208 Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic 30-Sep-08 2
implant)
21209 Osteoplasty, facial bones; reduction 30-Sep-08 2
21210 Graft, bone; nasal, maxillary or malar areas (includes obtaining graft) 30-Sep-08 2
21215 Graft, bone; mandible (includes obtaining graft) 30-Sep-08 2
21230 Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining 30-Sep-08 2
graft)
21235 Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft) 30-Sep-08 2
21240 Arthroplasty, temporomandibular joint, with or without autograft (includes 30-Sep-08 2

obtaining graft)
21242 Arthroplasty, temporomandibular joint, with allograft 30-Sep-08 2
21243 Arthroplasty, temporomandibular joint, with prosthetic joint replacement 30-Sep-08 2
21244 Reconstruction of mandible, extraoral, with transosteal bone plate (eg, 30-Sep-08 1
mandibular staple bone plate)
21245 Reconstruction of mandible or maxilla, subperiosteal implant; partial 30-Sep-08 2
21246 Reconstruction of mandible or maxilla, subperiosteal implant; complete 30-Sep-08 2
21247 Reconstruction of mandibular condyle with bone and cartilage autografts 30-Sep-08 2
(includes obtaining grafts) (eg, for hemifacial microsomia)
21248 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); 30-Sep-08
partial
21249 Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); 30-Sep-08
complete
21255 Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage 30-Sep-08 2
(includes obtaining autografts)
21256 Reconstruction of orbit with osteotomies (extracranial) and with bone grafts 30-Sep-08 2
(includes obtaining autografts) (eg, micro-ophthalmia)
21260 Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial 30-Sep-08 1
approach
21261 Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined 30-Sep-08 1
intra- and extracranial approach
21263 Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead 30-Sep-08 1
advancement
21267 Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; 30-Sep-08 2
extracranial approach
21268 Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; 30-Sep-08 2
combined intra- and extracranial approach
21270 Malar augmentation, prosthetic material 30-Sep-08 2
21275 Secondary revision of orbitocraniofacial reconstruction 30-Sep-08 1
21280 Medial canthopexy (separate procedure) 30-Sep-08 2
21282 Lateral canthopexy 30-Sep-08 2
21295 Reduction of masseter muscle and bone (eg, for treatment of benign masseteric 30-Sep-08 2
hypertrophy); extraoral approach
21296 Reduction of masseter muscle and bone (eg, for treatment of benign masseteric 30-Sep-08 2
hypertrophy); intraoral approach
21299 Unlisted craniofacial and maxillofacial procedure 30-Sep-08
21310 Closed treatment of nasal bone fracture without manipulation 30-Sep-08 1

21315 Closed treatment of nasal bone fracture; without stabilization 30-Sep-08 1
21320 Closed treatment of nasal bone fracture; with stabilization 30-Sep-08 1
21325 Open treatment of nasal fracture; uncomplicated 30-Sep-08 1
21330 Open treatment of nasal fracture; complicated, with internal and/or external 30-Sep-08 1
skeletal fixation
21335 Open treatment of nasal fracture; with concomitant open treatment of fractured 30-Sep-08 1
septum
21336 Open treatment of nasal septal fracture, with or without stabilization 30-Sep-08 1
21337 Closed treatment of nasal septal fracture, with or without stabilization 30-Sep-08 1
21338 Open treatment of nasoethmoid fracture; without external fixation 30-Sep-08 1

21339 Open treatment of nasoethmoid fracture; with external fixation 30-Sep-08 1
21340 Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or 30-Sep-08 1
headcap fixation, including repair of canthal ligaments and/or the nasolacrimal
apparatus
21343 Open treatment of depressed frontal sinus fracture 30-Sep-08 1
21344 Open treatment of complicated (eg, comminuted or involving posterior wall) 30-Sep-08 1
frontal sinus fracture, via coronal or multiple approaches
21345 Closed treatment of nasomaxillary complex fracture (LeFort II type), with 30-Sep-08 1
interdental wire fixation or fixation of denture or splint
21346 Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring 30-Sep-08 1
and/or local fixation
21347 Open treatment of nasomaxillary complex fracture (LeFort II type); requiring 30-Sep-08 1
multiple open approaches
21348 Open treatment of nasomaxillary complex fracture (LeFort II type); with bone 30-Sep-08 1
grafting (includes obtaining graft)
21355 Percutaneous treatment of fracture of malar area, including zygomatic arch and 30-Sep-08 2
malar tripod, with manipulation
21356 Open treatment of depressed zygomatic arch fracture (eg, Gillies approach) 30-Sep-08 2
21360 Open treatment of depressed malar fracture, including zygomatic arch and 30-Sep-08 2
malar tripod
21365 Open treatment of complicated (eg, comminuted or involving cranial nerve 30-Sep-08 2
foramina) fracture(s) of malar area, including zygomatic arch and malar tripod;
with internal fixation and multiple surgical approaches
21366 Open treatment of complicated (eg, comminuted or involving cranial nerve 30-Sep-08 2
foramina) fracture(s) of malar area, including zygomatic arch and malar tripod;
with bone grafting (includes obtaining graft)
21385 Open treatment of orbital floor blowout fracture; transantral approach (Caldwell- 30-Sep-08 2
Luc type operation)
21386 Open treatment of orbital floor blowout fracture; periorbital approach 30-Sep-08 2
21387 Open treatment of orbital floor blowout fracture; combined approach 30-Sep-08 2
21390 Open treatment of orbital floor blowout fracture; periorbital approach, with 30-Sep-08 2
alloplastic or other implant
21395 Open treatment of orbital floor blowout fracture; periorbital approach with bone 30-Sep-08 2
graft (includes obtaining graft)
21400 Closed treatment of fracture of orbit, except blowout; without manipulation 30-Sep-08 2
21401 Closed treatment of fracture of orbit, except blowout; with manipulation 30-Sep-08 2
21406 Open treatment of fracture of orbit, except blowout; without implant 30-Sep-08 2
21407 Open treatment of fracture of orbit, except blowout; with implant 30-Sep-08 2
21408 Open treatment of fracture of orbit, except blowout; with bone grafting (includes 30-Sep-08 2
obtaining graft)
21421 Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental 30-Sep-08 1
wire fixation or fixation of denture or splint
21422 Open treatment of palatal or maxillary fracture (LeFort I type); 30-Sep-08 1
21423 Open treatment of palatal or maxillary fracture (LeFort I type); complicated 30-Sep-08 1
(comminuted or involving cranial nerve foramina), multiple approaches
21431 Closed treatment of craniofacial separation (LeFort III type) using interdental 30-Sep-08 1
wire fixation of denture or splint
21432 Open treatment of craniofacial separation (LeFort III type); with wiring and/or 30-Sep-08 1
internal fixation
21433 Open treatment of craniofacial separation (LeFort III type); complicated (eg, 30-Sep-08 1
comminuted or involving cranial nerve foramina), multiple surgical approaches
21435 Open treatment of craniofacial separation (LeFort III type); complicated, utilizing 30-Sep-08 1
internal and/or external fixation techniques (eg, head cap, halo device, and/or
intermaxillary fixation)
21436 Open treatment of craniofacial separation (LeFort III type); complicated, multiple 30-Sep-08 1
surgical approaches, internal fixation, with bone grafting (includes obtaining
graft)
21440 Closed treatment of mandibular or maxillary alveolar ridge fracture (separate 30-Sep-08 2
procedure)
21445 Open treatment of mandibular or maxillary alveolar ridge fracture (separate 30-Sep-08 2
procedure)
21450 Closed treatment of mandibular fracture; without manipulation 30-Sep-08 1
21451 Closed treatment of mandibular fracture; with manipulation 30-Sep-08 1
21452 Percutaneous treatment of mandibular fracture, with external fixation 30-Sep-08 1
21453 Closed treatment of mandibular fracture with interdental fixation 30-Sep-08 1

21454 Open treatment of mandibular fracture with external fixation 30-Sep-08 1
21461 Open treatment of mandibular fracture; without interdental fixation 30-Sep-08 1
21462 Open treatment of mandibular fracture; with interdental fixation 30-Sep-08 1
21465 Open treatment of mandibular condylar fracture 30-Sep-08 2
21470 Open treatment of complicated mandibular fracture by multiple surgical 30-Sep-08 1
approaches including internal fixation, interdental fixation, and/or wiring of
dentures or splints
21480 Closed treatment of temporomandibular dislocation; initial or subsequent 30-Sep-08 2
21485 Closed treatment of temporomandibular dislocation; complicated (eg, recurrent 30-Sep-08 2

requiring intermaxillary fixation or splinting), initial or subsequent
21490 Open treatment of temporomandibular dislocation 30-Sep-08 2

21495 Open treatment of hyoid fracture 30-Sep-08 1
21497 Interdental wiring, for condition other than fracture 30-Sep-08 1
21499 Unlisted musculoskeletal procedure, head 30-Sep-08
21501 Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; 30-Sep-08 3
21502 Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax; 30-Sep-08 1
with partial rib ostectomy
21510 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone 30-Sep-08 1
abscess), thorax
21550 Biopsy, soft tissue of neck or thorax 30-Sep-08 3
21552 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or 15-Oct-12
greater
21554 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, 15-Oct-12
21555 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 30-Sep-08
cm
21556 Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, 30-Sep-08 3
21557 Radical resection of tumor (eg, malignant neoplasm), soft tissue of neck or 30-Sep-08 1
anterior thorax; less than 5 cm
21558 Radical resection of tumor (eg, malignant neoplasm), soft tissue of neck or 15-Oct-12
anterior thorax; 5 cm or greater
21600 Excision of rib, partial 30-Sep-08
21610 Costotransversectomy (separate procedure) 30-Sep-08 2
21615 Excision first and/or cervical rib; 30-Sep-08 2
21616 Excision first and/or cervical rib; with sympathectomy 30-Sep-08 2
21620 Ostectomy of sternum, partial 30-Sep-08 1
21627 Sternal debridement 30-Sep-08 1
21630 Radical resection of sternum; 30-Sep-08 1
21632 Radical resection of sternum; with mediastinal lymphadenectomy 30-Sep-08 1
21685 Hyoid myotomy and suspension 30-Sep-08 1
21700 Division of scalenus anticus; without resection of cervical rib 30-Sep-08 2
21705 Division of scalenus anticus; with resection of cervical rib 30-Sep-08 2
21720 Division of sternocleidomastoid for torticollis, open operation; without cast 30-Sep-08 1
application
21725 Division of sternocleidomastoid for torticollis, open operation; with cast 30-Sep-08 1
application
21740 Reconstructive repair of pectus excavatum or carinatum; open 30-Sep-08 1
21742 Reconstructive repair of pectus excavatum or carinatum; minimally invasive 30-Sep-08 1
approach (Nuss procedure), without thoracoscopy
21743 Reconstructive repair of pectus excavatum or carinatum; minimally invasive 30-Sep-08 1
approach (Nuss procedure), with thoracoscopy
21750 Closure of median sternotomy separation with or without debridement (separate 30-Sep-08 1
procedure)
21800 Closed treatment of rib fracture, uncomplicated, each 30-Sep-08
21805 Open treatment of rib fracture without fixation, each 30-Sep-08 3
21810 Treatment of rib fracture requiring external fixation (flail chest) 30-Sep-08 1
21820 Closed treatment of sternum fracture 30-Sep-08 1
21825 Open treatment of sternum fracture with or without skeletal fixation 30-Sep-08 1
21899 Unlisted procedure, neck or thorax 30-Sep-08
21920 Biopsy, soft tissue of back or flank; superficial 30-Sep-08 3

21925 Biopsy, soft tissue of back or flank; deep 30-Sep-08 3
21930 Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm 30-Sep-08
21931 Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater 15-Oct-12
21932 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); less 15-Oct-12
than 5 cm
21933 Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm 15-Oct-12
or greater
21935 Radical resection of tumor (eg, malignant neoplasm), soft tissue of back or flank; 30-Sep-08 1
less than 5 cm
21936 Radical resection of tumor (eg, malignant neoplasm), soft tissue of back or flank; 15-Oct-12
5 cm or greater
22010 Incision and drainage, open, of deep abscess (subfascial), posterior spine; 30-Sep-08 2
cervical, thoracic, or cervicothoracic
22015 Incision and drainage, open, of deep abscess (subfascial), posterior spine; 30-Sep-08 2
lumbar, sacral, or lumbosacral
22100 Partial excision of posterior vertebral component (eg, spinous process, lamina or 30-Sep-08 1
facet) for intrinsic bony lesion, single vertebral segment; cervical
facet) for intrinsic bony lesion, single vertebral segment; thoracic
facet) for intrinsic bony lesion, single vertebral segment; lumbar
facet) for intrinsic bony lesion, single vertebral segment; each additional
segment (List separately in addition to code for primary procedure)
22110 Partial excision of vertebral body, for intrinsic bony lesion, without 30-Sep-08 1
decompression of spinal cord or nerve root(s), single vertebral segment; cervical
decompression of spinal cord or nerve root(s), single vertebral segment; thoracic
decompression of spinal cord or nerve root(s), single vertebral segment; lumbar
decompression of spinal cord or nerve root(s), single vertebral segment; each
procedure)
22206 Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral 30-Sep-08 1
segment (eg, pedicle/vertebral body subtraction); thoracic
22207 Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral 30-Sep-08 1
segment (eg, pedicle/vertebral body subtraction); lumbar
22208 Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral 30-Sep-08
segment (eg, pedicle/vertebral body subtraction); each additional vertebral
22210 Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; 30-Sep-08 1

cervical
thoracic
lumbar
each additional vertebral segment (List separately in addition to primary
procedure)
22220 Osteotomy of spine, including discectomy, anterior approach, single vertebral 30-Sep-08 1
segment; cervical
segment; thoracic
segment; lumbar
22226 Osteotomy of spine, including discectomy, anterior approach, single vertebral 30-Sep-08
segment; each additional vertebral segment (List separately in addition to code
22305 Closed treatment of vertebral process fracture(s) 30-Sep-08 1
22310 Closed treatment of vertebral body fracture(s), without manipulation, requiring 30-Sep-08 1
and including casting or bracing
22315 Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting 30-Sep-08 1
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) 30-Sep-08 1
(including os odontoideum), anterior approach, including placement of internal
fixation; without grafting
22319 Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) 30-Sep-08 1
(including os odontoideum), anterior approach, including placement of internal
fixation; with grafting
22325 Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), 30-Sep-08 1
posterior approach, 1 fractured vertebra or dislocated segment; lumbar
posterior approach, 1 fractured vertebra or dislocated segment; cervical
posterior approach, 1 fractured vertebra or dislocated segment; thoracic
posterior approach, 1 fractured vertebra or dislocated segment; each additional
fractured vertebra or dislocated segment (List separately in addition to code for
primary procedure)
22505 Manipulation of spine requiring anesthesia, any region 30-Sep-08 1
22520 Percutaneous vertebroplasty, 1 vertebral body, unilateral or bilateral injection; 30-Sep-08 1
thoracic
lumbar
each additional thoracic or lumbar vertebral body (List separately in addition to
22523 Percutaneous vertebral augmentation, including cavity creation (fracture 30-Sep-08 1
reduction and bone biopsy included when performed) using mechanical device,
1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); thoracic

1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); lumbar

1 vertebral body, unilateral or bilateral cannulation (eg, kyphoplasty); each
additional thoracic or lumbar vertebral body (List separately in addition to code
22526 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral 30-Sep-08

including fluoroscopic guidance; single level
22527 Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral 30-Sep-08
including fluoroscopic guidance; 1 or more additional levels (List separately in
22532 Arthrodesis, lateral extracavitary technique, including minimal discectomy to 30-Sep-08 1
prepare interspace (other than for decompression); thoracic

prepare interspace (other than for decompression); lumbar

prepare interspace (other than for decompression); thoracic or lumbar, each
procedure)
22548 Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), 30-Sep-08 1
with or without excision of odontoid process
22551 Arthrodesis, anterior interbody, including disc space preparation, discectomy, 15-Oct-12 1
osteophytectomy and decompression of spinal cord and/or nerve roots; cervical
below C2
22552 Arthrodesis, anterior interbody, including disc space preparation, discectomy, 15-Oct-12
osteophytectomy and decompression of spinal cord and/or nerve roots; cervical
below C2, each additional interspace (List separately in addition to code for
separate procedure)
22554 Arthrodesis, anterior interbody technique, including minimal discectomy to 30-Sep-08 1
prepare interspace (other than for decompression); cervical below C2

prepare interspace (other than for decompression); thoracic

prepare interspace (other than for decompression); lumbar

prepare interspace (other than for decompression); each additional interspace
22590 Arthrodesis, posterior technique, craniocervical (occiput-C2) 30-Sep-08 1

22595 Arthrodesis, posterior technique, atlas-axis (C1-C2) 30-Sep-08 1
22600 Arthrodesis, posterior or posterolateral technique, single level; cervical below C2 30-Sep-08 1
segment
22610 Arthrodesis, posterior or posterolateral technique, single level; thoracic (with or 30-Sep-08 1
without lateral transverse technique)
22612 Arthrodesis, posterior or posterolateral technique, single level; lumbar (with or 30-Sep-08 1
without lateral transverse technique)
22614 Arthrodesis, posterior or posterolateral technique, single level; each additional 30-Sep-08 15
vertebral segment (List separately in addition to code for primary procedure)
22630 Arthrodesis, posterior interbody technique, including laminectomy and/or 30-Sep-08 1

discectomy to prepare interspace (other than for decompression), single
interspace; lumbar
22632 Arthrodesis, posterior interbody technique, including laminectomy and/or 30-Sep-08 4
discectomy to prepare interspace (other than for decompression), single
interspace; each additional interspace (List separately in addition to code for
primary procedure)
22800 Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 30-Sep-08 1
vertebral segments
22802 Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 30-Sep-08 1
vertebral segments
22804 Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more 30-Sep-08 1
vertebral segments
22808 Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral 30-Sep-08 1
segments
22810 Arthrodesis, anterior, for spinal deformity, with or without cast; 4 to 7 vertebral 30-Sep-08 1
segments
22812 Arthrodesis, anterior, for spinal deformity, with or without cast; 8 or more 30-Sep-08 1
vertebral segments
22818 Kyphectomy, circumferential exposure of spine and resection of vertebral 30-Sep-08 1
segment(s) (including body and posterior elements); single or 2 segments
22819 Kyphectomy, circumferential exposure of spine and resection of vertebral 30-Sep-08 1

segment(s) (including body and posterior elements); 3 or more segments
22830 Exploration of spinal fusion 30-Sep-08 1

22840 Posterior non-segmental instrumentation (eg, Harrington rod technique, pedicle 30-Sep-08 1
fixation across 1 interspace, atlantoaxial transarticular screw fixation,
sublaminar wiring at C1, facet screw fixation) (List separately in addition to code
22841 Internal spinal fixation by wiring of spinous processes (List separately in addition 30-Sep-08
22842 Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple 30-Sep-08 1
hooks and sublaminar wires); 3 to 6 vertebral segments (List separately in
hooks and sublaminar wires); 7 to 12 vertebral segments (List separately in
hooks and sublaminar wires); 13 or more vertebral segments (List separately in
22845 Anterior instrumentation; 2 to 3 vertebral segments (List separately in addition 30-Sep-08 1
22846 Anterior instrumentation; 4 to 7 vertebral segments (List separately in addition 30-Sep-08 1
22847 Anterior instrumentation; 8 or more vertebral segments (List separately in 30-Sep-08 1
22848 Pelvic fixation (attachment of caudal end of instrumentation to pelvic bony 30-Sep-08 1
structures) other than sacrum (List separately in addition to code for primary
procedure)
22849 Reinsertion of spinal fixation device 30-Sep-08 1
22850 Removal of posterior nonsegmental instrumentation (eg, Harrington rod) 30-Sep-08 1
22851 Application of intervertebral biomechanical device(s) (eg, synthetic cage(s), 30-Sep-08 9

methylmethacrylate) to vertebral defect or interspace (List separately in
22852 Removal of posterior segmental instrumentation 30-Sep-08 1
22855 Removal of anterior instrumentation 30-Sep-08 1
22856 Total disc arthroplasty (artificial disc), anterior approach, including discectomy 15-Oct-12
with end plate preparation (includes osteophytectomy for nerve root or spinal
cord decompression and microdissection), single interspace, cervical
22857 Total disc arthroplasty (artificial disc), anterior approach, including discectomy to 30-Sep-08 1
prepare interspace (other than for decompression), single interspace, lumbar
22861 Revision including replacement of total disc arthroplasty (artificial disc), anterior 15-Oct-12
approach, single interspace; cervical
22862 Revision including replacement of total disc arthroplasty (artificial disc), anterior 30-Sep-08 1
approach, single interspace; lumbar
22864 Removal of total disc arthroplasty (artificial disc), anterior approach, single 15-Oct-12
interspace; cervical
22865 Removal of total disc arthroplasty (artificial disc), anterior approach, single 30-Sep-08 1
interspace; lumbar
22899 Unlisted procedure, spine 30-Sep-08
22900 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 30-Sep-08 3
less than 5 cm
22901 Excision, tumor, soft tissue of abdominal wall, subfascial (eg, intramuscular); 5 15-Oct-12
cm or greater
22902 Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm 15-Oct-12
22903 Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater 15-Oct-12
22904 Radical resection of tumor (eg, malignant neoplasm), soft tissue of abdominal 15-Oct-12
wall; less than 5 cm
22905 Radical resection of tumor (eg, malignant neoplasm), soft tissue of abdominal 15-Oct-12
wall; 5 cm or greater
22999 Unlisted procedure, abdomen, musculoskeletal system 30-Sep-08
23000 Removal of subdeltoid calcareous deposits, open 30-Sep-08 2

23020 Capsular contracture release (eg, Sever type procedure) 30-Sep-08 2
23030 Incision and drainage, shoulder area; deep abscess or hematoma 30-Sep-08 2
23031 Incision and drainage, shoulder area; infected bursa 30-Sep-08 2
23035 Incision, bone cortex (eg, osteomyelitis or bone abscess), shoulder area 30-Sep-08 2
23040 Arthrotomy, glenohumeral joint, including exploration, drainage, or removal of 30-Sep-08 2

foreign body
23044 Arthrotomy, acromioclavicular, sternoclavicular joint, including exploration, 30-Sep-08 2
drainage, or removal of foreign body
23065 Biopsy, soft tissue of shoulder area; superficial 30-Sep-08 2
23066 Biopsy, soft tissue of shoulder area; deep 30-Sep-08 2
23071 Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater 15-Oct-12
23073 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); 5 cm 15-Oct-12
or greater
23075 Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm 30-Sep-08 4
23076 Excision, tumor, soft tissue of shoulder area, subfascial (eg, intramuscular); less 30-Sep-08 2
than 5 cm
23077 Radical resection of tumor (eg, malignant neoplasm), soft tissue of shoulder 30-Sep-08 1
area; less than 5 cm
23078 Radical resection of tumor (eg, malignant neoplasm), soft tissue of shoulder 15-Oct-12
area; 5 cm or greater
23100 Arthrotomy, glenohumeral joint, including biopsy 30-Sep-08 2
23101 Arthrotomy, acromioclavicular joint or sternoclavicular joint, including biopsy 30-Sep-08 2
and/or excision of torn cartilage
23105 Arthrotomy; glenohumeral joint, with synovectomy, with or without biopsy 30-Sep-08 2
23106 Arthrotomy; sternoclavicular joint, with synovectomy, with or without biopsy 30-Sep-08 2
23107 Arthrotomy, glenohumeral joint, with joint exploration, with or without removal 30-Sep-08 2
of loose or foreign body
23120 Claviculectomy; partial 30-Sep-08 2
23125 Claviculectomy; total 30-Sep-08 2
23130 Acromioplasty or acromionectomy, partial, with or without coracoacromial 30-Sep-08 2
ligament release
23140 Excision or curettage of bone cyst or benign tumor of clavicle or scapula; 30-Sep-08
23145 Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with 30-Sep-08 1
autograft (includes obtaining graft)
23146 Excision or curettage of bone cyst or benign tumor of clavicle or scapula; with 30-Sep-08 1
allograft
23150 Excision or curettage of bone cyst or benign tumor of proximal humerus; 30-Sep-08 1
23155 Excision or curettage of bone cyst or benign tumor of proximal humerus; with 30-Sep-08 1
23156 Excision or curettage of bone cyst or benign tumor of proximal humerus; with 30-Sep-08 1
allograft
23170 Sequestrectomy (eg, for osteomyelitis or bone abscess), clavicle 30-Sep-08 1
23172 Sequestrectomy (eg, for osteomyelitis or bone abscess), scapula 30-Sep-08 1
23174 Sequestrectomy (eg, for osteomyelitis or bone abscess), humeral head to 30-Sep-08 1
surgical neck
23180 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, 30-Sep-08 1
osteomyelitis), clavicle
osteomyelitis), scapula
osteomyelitis), proximal humerus
23190 Ostectomy of scapula, partial (eg, superior medial angle) 30-Sep-08 1
23195 Resection, humeral head 30-Sep-08 1
23200 Radical resection of tumor; clavicle 30-Sep-08 1
23210 Radical resection of tumor; scapula 30-Sep-08 1
23220 Radical resection of tumor, proximal humerus 30-Sep-08 1
23221 Radical resection of bone tumor, proximal humerus; with autograft (includes 30-Sep-08 14-Oct-12
obtaining graft)
23222 Radical resection of bone tumor, proximal humerus; with prosthetic replacement 30-Sep-08 14-Oct-12
23330 Removal of foreign body, shoulder; subcutaneous 30-Sep-08 2

23331 Removal of foreign body, shoulder; deep (eg, Neer hemiarthroplasty removal) 30-Sep-08 2
23332 Removal of foreign body, shoulder; complicated (eg, total shoulder) 30-Sep-08 2
23350 Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder 30-Sep-08 2
arthrography
23395 Muscle transfer, any type, shoulder or upper arm; single 30-Sep-08 1
23397 Muscle transfer, any type, shoulder or upper arm; multiple 30-Sep-08 1
23400 Scapulopexy (eg, Sprengels deformity or for paralysis) 30-Sep-08 1
23405 Tenotomy, shoulder area; single tendon 30-Sep-08 2
23406 Tenotomy, shoulder area; multiple tendons through same incision 30-Sep-08 2
23410 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; acute 30-Sep-08 2
23412 Repair of ruptured musculotendinous cuff (eg, rotator cuff) open; chronic 30-Sep-08 2
23415 Coracoacromial ligament release, with or without acromioplasty 30-Sep-08 2

23420 Reconstruction of complete shoulder (rotator) cuff avulsion, chronic (includes 30-Sep-08 2
acromioplasty)
23430 Tenodesis of long tendon of biceps 30-Sep-08 2
23440 Resection or transplantation of long tendon of biceps 30-Sep-08 2
23450 Capsulorrhaphy, anterior; Putti-Platt procedure or Magnuson type operation 30-Sep-08 2
23455 Capsulorrhaphy, anterior; with labral repair (eg, Bankart procedure) 30-Sep-08 2
23460 Capsulorrhaphy, anterior, any type; with bone block 30-Sep-08 2
23462 Capsulorrhaphy, anterior, any type; with coracoid process transfer 30-Sep-08 2
23465 Capsulorrhaphy, glenohumeral joint, posterior, with or without bone block 30-Sep-08 2
23466 Capsulorrhaphy, glenohumeral joint, any type multi-directional instability 30-Sep-08 2
23470 Arthroplasty, glenohumeral joint; hemiarthroplasty 30-Sep-08 2

23472 Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral 30-Sep-08 2
replacement (eg, total shoulder))
23480 Osteotomy, clavicle, with or without internal fixation; 30-Sep-08 2
23485 Osteotomy, clavicle, with or without internal fixation; with bone graft for 30-Sep-08 2
nonunion or malunion (includes obtaining graft and/or necessary fixation)
23490 Prophylactic treatment (nailing, pinning, plating or wiring) with or without 30-Sep-08 2
methylmethacrylate; clavicle
methylmethacrylate; proximal humerus
23500 Closed treatment of clavicular fracture; without manipulation 30-Sep-08 2
23505 Closed treatment of clavicular fracture; with manipulation 30-Sep-08 2
23515 Open treatment of clavicular fracture, includes internal fixation, when performed 30-Sep-08 2
23520 Closed treatment of sternoclavicular dislocation; without manipulation 30-Sep-08 2
23525 Closed treatment of sternoclavicular dislocation; with manipulation 30-Sep-08 2

23530 Open treatment of sternoclavicular dislocation, acute or chronic; 30-Sep-08 2
23532 Open treatment of sternoclavicular dislocation, acute or chronic; with fascial 30-Sep-08 2
23540 Closed treatment of acromioclavicular dislocation; without manipulation 30-Sep-08 2
23545 Closed treatment of acromioclavicular dislocation; with manipulation 30-Sep-08 2

23550 Open treatment of acromioclavicular dislocation, acute or chronic; 30-Sep-08 2
23552 Open treatment of acromioclavicular dislocation, acute or chronic; with fascial 30-Sep-08 2
23570 Closed treatment of scapular fracture; without manipulation 30-Sep-08 2
23575 Closed treatment of scapular fracture; with manipulation, with or without 30-Sep-08 2
skeletal traction (with or without shoulder joint involvement)
23585 Open treatment of scapular fracture (body, glenoid or acromion) includes 30-Sep-08 2
internal fixation, when performed
23600 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; 30-Sep-08 2
without manipulation
23605 Closed treatment of proximal humeral (surgical or anatomical neck) fracture; 30-Sep-08 2
with manipulation, with or without skeletal traction
23615 Open treatment of proximal humeral (surgical or anatomical neck) fracture, 30-Sep-08 2
includes internal fixation, when performed, includes repair of tuberosity(s), when
performed;
23616 Open treatment of proximal humeral (surgical or anatomical neck) fracture, 30-Sep-08 2
includes internal fixation, when performed, includes repair of tuberosity(s), when
performed; with proximal humeral prosthetic replacement
23620 Closed treatment of greater humeral tuberosity fracture; without manipulation 30-Sep-08 2
23625 Closed treatment of greater humeral tuberosity fracture; with manipulation 30-Sep-08 2
23630 Open treatment of greater humeral tuberosity fracture, includes internal fixation, 30-Sep-08 2
when performed
23650 Closed treatment of shoulder dislocation, with manipulation; without anesthesia 30-Sep-08 2
23655 Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia 30-Sep-08 2
23660 Open treatment of acute shoulder dislocation 30-Sep-08 2

23665 Closed treatment of shoulder dislocation, with fracture of greater humeral 30-Sep-08 2
tuberosity, with manipulation
23670 Open treatment of shoulder dislocation, with fracture of greater humeral 30-Sep-08 2
tuberosity, includes internal fixation, when performed
23675 Closed treatment of shoulder dislocation, with surgical or anatomical neck 30-Sep-08 2
fracture, with manipulation
23680 Open treatment of shoulder dislocation, with surgical or anatomical neck 30-Sep-08 2
fracture, includes internal fixation, when performed
23700 Manipulation under anesthesia, shoulder joint, including application of fixation 30-Sep-08 2
apparatus (dislocation excluded)
23800 Arthrodesis, glenohumeral joint; 30-Sep-08 2
23802 Arthrodesis, glenohumeral joint; with autogenous graft (includes obtaining graft) 30-Sep-08 2
23900 Interthoracoscapular amputation (forequarter) 30-Sep-08 1

23920 Disarticulation of shoulder; 30-Sep-08 2
23921 Disarticulation of shoulder; secondary closure or scar revision 30-Sep-08 2
23929 Unlisted procedure, shoulder 30-Sep-08
23930 Incision and drainage, upper arm or elbow area; deep abscess or hematoma 30-Sep-08 2
23931 Incision and drainage, upper arm or elbow area; bursa 30-Sep-08 2
23935 Incision, deep, with opening of bone cortex (eg, for osteomyelitis or bone 30-Sep-08 2
abscess), humerus or elbow
24000 Arthrotomy, elbow, including exploration, drainage, or removal of foreign body 30-Sep-08 2
24006 Arthrotomy of the elbow, with capsular excision for capsular release (separate 30-Sep-08 2
procedure)
24065 Biopsy, soft tissue of upper arm or elbow area; superficial 30-Sep-08 2
24066 Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular) 30-Sep-08 2
24071 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or 15-Oct-12
greater
24073 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, 15-Oct-12
24075 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 30-Sep-08
3 cm
24076 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (eg, 30-Sep-08
24077 Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper arm or 30-Sep-08 2
elbow area; less than 5 cm
24079 Radical resection of tumor (eg, malignant neoplasm), soft tissue of upper arm or 15-Oct-12
elbow area; 5 cm or greater
24100 Arthrotomy, elbow; with synovial biopsy only 30-Sep-08 2
24101 Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without 30-Sep-08 2
removal of loose or foreign body
24102 Arthrotomy, elbow; with synovectomy 30-Sep-08 2
24105 Excision, olecranon bursa 30-Sep-08 2
24110 Excision or curettage of bone cyst or benign tumor, humerus; 30-Sep-08 1
24115 Excision or curettage of bone cyst or benign tumor, humerus; with autograft 30-Sep-08 2
(includes obtaining graft)
24116 Excision or curettage of bone cyst or benign tumor, humerus; with allograft 30-Sep-08 1
24120 Excision or curettage of bone cyst or benign tumor of head or neck of radius or 30-Sep-08 2
olecranon process;
olecranon process; with autograft (includes obtaining graft)
olecranon process; with allograft
24130 Excision, radial head 30-Sep-08 2
24134 Sequestrectomy (eg, for osteomyelitis or bone abscess), shaft or distal humerus 30-Sep-08 1
24136 Sequestrectomy (eg, for osteomyelitis or bone abscess), radial head or neck 30-Sep-08 1
24138 Sequestrectomy (eg, for osteomyelitis or bone abscess), olecranon process 30-Sep-08 2

osteomyelitis), humerus
osteomyelitis), radial head or neck
osteomyelitis), olecranon process
24149 Radical resection of capsule, soft tissue, and heterotopic bone, elbow, with 30-Sep-08 2
contracture release (separate procedure)
24150 Radical resection of tumor, shaft or distal humerus 30-Sep-08 1
24151 Radical resection for tumor, shaft or distal humerus; with autograft (includes 30-Sep-08 14-Oct-12
obtaining graft)
24152 Radical resection of tumor, radial head or neck 30-Sep-08 1
24153 Radical resection for tumor, radial head or neck; with autograft (includes 30-Sep-08 14-Oct-12
obtaining graft)
24155 Resection of elbow joint (arthrectomy) 30-Sep-08 2
24160 Implant removal; elbow joint 30-Sep-08 2
24164 Implant removal; radial head 30-Sep-08 2
24200 Removal of foreign body, upper arm or elbow area; subcutaneous 30-Sep-08 3
24201 Removal of foreign body, upper arm or elbow area; deep (subfascial or 30-Sep-08 3
intramuscular)
24220 Injection procedure for elbow arthrography 30-Sep-08 2
24300 Manipulation, elbow, under anesthesia 30-Sep-08 2
24301 Muscle or tendon transfer, any type, upper arm or elbow, single (excluding 30-Sep-08 2
24320-24331)
24305 Tendon lengthening, upper arm or elbow, each tendon 30-Sep-08 4
24310 Tenotomy, open, elbow to shoulder, each tendon 30-Sep-08
24320 Tenoplasty, with muscle transfer, with or without free graft, elbow to shoulder, 30-Sep-08 2
single (Seddon-Brookes type procedure)
24330 Flexor-plasty, elbow (eg, Steindler type advancement); 30-Sep-08 2
24331 Flexor-plasty, elbow (eg, Steindler type advancement); with extensor 30-Sep-08 2
advancement
24332 Tenolysis, triceps 30-Sep-08 2
24340 Tenodesis of biceps tendon at elbow (separate procedure) 30-Sep-08 2
24341 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary 30-Sep-08
or secondary (excludes rotator cuff)
24342 Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon 30-Sep-08 2
graft
24343 Repair lateral collateral ligament, elbow, with local tissue 30-Sep-08 2
24344 Reconstruction lateral collateral ligament, elbow, with tendon graft (includes 30-Sep-08 2
harvesting of graft)
24345 Repair medial collateral ligament, elbow, with local tissue 30-Sep-08 2
24346 Reconstruction medial collateral ligament, elbow, with tendon graft (includes 30-Sep-08 2
harvesting of graft)
24357 Tenotomy, elbow, lateral or medial (eg, epicondylitis, tennis elbow, golfer's 30-Sep-08 2
elbow); percutaneous
elbow); debridement, soft tissue and/or bone, open
elbow); debridement, soft tissue and/or bone, open with tendon repair or
reattachment
24360 Arthroplasty, elbow; with membrane (eg, fascial) 30-Sep-08 2
24361 Arthroplasty, elbow; with distal humeral prosthetic replacement 30-Sep-08 2
24362 Arthroplasty, elbow; with implant and fascia lata ligament reconstruction 30-Sep-08 2
24363 Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic 30-Sep-08 2
replacement (eg, total elbow)
24365 Arthroplasty, radial head; 30-Sep-08 2
24366 Arthroplasty, radial head; with implant 30-Sep-08 2
24400 Osteotomy, humerus, with or without internal fixation 30-Sep-08 2
24410 Multiple osteotomies with realignment on intramedullary rod, humeral shaft 30-Sep-08 2
(Sofield type procedure)
24420 Osteoplasty, humerus (eg, shortening or lengthening) (excluding 64876) 30-Sep-08 2
24430 Repair of nonunion or malunion, humerus; without graft (eg, compression 30-Sep-08 2
technique)
24435 Repair of nonunion or malunion, humerus; with iliac or other autograft (includes 30-Sep-08 2
obtaining graft)
24470 Hemiepiphyseal arrest (eg, cubitus varus or valgus, distal humerus) 30-Sep-08 2
24495 Decompression fasciotomy, forearm, with brachial artery exploration 30-Sep-08 2
24498 Prophylactic treatment (nailing, pinning, plating or wiring), with or without 30-Sep-08 2
methylmethacrylate, humeral shaft
24500 Closed treatment of humeral shaft fracture; without manipulation 30-Sep-08 2
24505 Closed treatment of humeral shaft fracture; with manipulation, with or without 30-Sep-08 2
skeletal traction
24515 Open treatment of humeral shaft fracture with plate/screws, with or without 30-Sep-08 2
cerclage
24516 Treatment of humeral shaft fracture, with insertion of intramedullary implant, 30-Sep-08 2
with or without cerclage and/or locking screws
24530 Closed treatment of supracondylar or transcondylar humeral fracture, with or 30-Sep-08 2
without intercondylar extension; without manipulation
24535 Closed treatment of supracondylar or transcondylar humeral fracture, with or 30-Sep-08 2
without intercondylar extension; with manipulation, with or without skin or
skeletal traction
24538 Percutaneous skeletal fixation of supracondylar or transcondylar humeral 30-Sep-08 2
fracture, with or without intercondylar extension
24545 Open treatment of humeral supracondylar or transcondylar fracture, includes 30-Sep-08 2
internal fixation, when performed; without intercondylar extension
24546 Open treatment of humeral supracondylar or transcondylar fracture, includes 30-Sep-08 2

internal fixation, when performed; with intercondylar extension
24560 Closed treatment of humeral epicondylar fracture, medial or lateral; without 30-Sep-08 2
manipulation
24565 Closed treatment of humeral epicondylar fracture, medial or lateral; with 30-Sep-08 2
manipulation
24566 Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, 30-Sep-08 2
with manipulation
24575 Open treatment of humeral epicondylar fracture, medial or lateral, includes 30-Sep-08 2
24576 Closed treatment of humeral condylar fracture, medial or lateral; without 30-Sep-08 2
manipulation
24577 Closed treatment of humeral condylar fracture, medial or lateral; with 30-Sep-08 2
manipulation
24579 Open treatment of humeral condylar fracture, medial or lateral, includes internal 30-Sep-08 2
fixation, when performed
24582 Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, 30-Sep-08 2
with manipulation
24586 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture 30-Sep-08 2
distal humerus and proximal ulna and/or proximal radius);
24587 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture 30-Sep-08 2
distal humerus and proximal ulna and/or proximal radius); with implant
arthroplasty
24600 Treatment of closed elbow dislocation; without anesthesia 30-Sep-08 2
24605 Treatment of closed elbow dislocation; requiring anesthesia 30-Sep-08 2
24615 Open treatment of acute or chronic elbow dislocation 30-Sep-08 2
24620 Closed treatment of Monteggia type of fracture dislocation at elbow (fracture 30-Sep-08 2
proximal end of ulna with dislocation of radial head), with manipulation
24635 Open treatment of Monteggia type of fracture dislocation at elbow (fracture 30-Sep-08 2
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 30-Sep-08 2
manipulation
24650 Closed treatment of radial head or neck fracture; without manipulation 30-Sep-08 2
24655 Closed treatment of radial head or neck fracture; with manipulation 30-Sep-08 2
24665 Open treatment of radial head or neck fracture, includes internal fixation or 30-Sep-08 2
radial head excision, when performed;
24666 Open treatment of radial head or neck fracture, includes internal fixation or 30-Sep-08 2
radial head excision, when performed; with radial head prosthetic replacement
24670 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid 30-Sep-08 2
process[es]); without manipulation
24675 Closed treatment of ulnar fracture, proximal end (eg, olecranon or coronoid 30-Sep-08 2
process[es]); with manipulation
24685 Open treatment of ulnar fracture, proximal end (eg, olecranon or coronoid 30-Sep-08 2
process[es]), includes internal fixation, when performed
24800 Arthrodesis, elbow joint; local 30-Sep-08 2
24802 Arthrodesis, elbow joint; with autogenous graft (includes obtaining graft) 30-Sep-08 2
24900 Amputation, arm through humerus; with primary closure 30-Sep-08 2

24920 Amputation, arm through humerus; open, circular (guillotine) 30-Sep-08 2
24925 Amputation, arm through humerus; secondary closure or scar revision 30-Sep-08 2
24930 Amputation, arm through humerus; re-amputation 30-Sep-08 2
24931 Amputation, arm through humerus; with implant 30-Sep-08 2
24935 Stump elongation, upper extremity 30-Sep-08 2
24940 Cineplasty, upper extremity, complete procedure 30-Sep-08 2
24999 Unlisted procedure, humerus or elbow 30-Sep-08
25000 Incision, extensor tendon sheath, wrist (eg, deQuervains disease) 30-Sep-08 2
25001 Incision, flexor tendon sheath, wrist (eg, flexor carpi radialis) 30-Sep-08 2
25020 Decompression fasciotomy, forearm and/or wrist, flexor OR extensor 30-Sep-08 2
compartment; without debridement of nonviable muscle and/or nerve
25023 Decompression fasciotomy, forearm and/or wrist, flexor OR extensor 30-Sep-08 2

compartment; with debridement of nonviable muscle and/or nerve
25024 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor 30-Sep-08 2
compartment; without debridement of nonviable muscle and/or nerve
25025 Decompression fasciotomy, forearm and/or wrist, flexor AND extensor 30-Sep-08 2
compartment; with debridement of nonviable muscle and/or nerve
25028 Incision and drainage, forearm and/or wrist; deep abscess or hematoma 30-Sep-08
25031 Incision and drainage, forearm and/or wrist; bursa 30-Sep-08 2

25035 Incision, deep, bone cortex, forearm and/or wrist (eg, osteomyelitis or bone 30-Sep-08 2
abscess)
25040 Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or 30-Sep-08 2
removal of foreign body
25065 Biopsy, soft tissue of forearm and/or wrist; superficial 30-Sep-08 5
25066 Biopsy, soft tissue of forearm and/or wrist; deep (subfascial or intramuscular) 30-Sep-08 3
25071 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or 15-Oct-12
greater
25073 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, 15-Oct-12
25075 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 30-Sep-08
3 cm
25076 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, 30-Sep-08 5
25077 Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm 30-Sep-08 2
and/or wrist area; less than 3 cm
25078 Radical resection of tumor (eg, malignant neoplasm), soft tissue of forearm 15-Oct-12
and/or wrist area; 3 cm or greater
25085 Capsulotomy, wrist (eg, contracture) 30-Sep-08 2
25100 Arthrotomy, wrist joint; with biopsy 30-Sep-08 2
25101 Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or 30-Sep-08 2
without removal of loose or foreign body
25105 Arthrotomy, wrist joint; with synovectomy 30-Sep-08 2
25107 Arthrotomy, distal radioulnar joint including repair of triangular cartilage, 30-Sep-08 2
complex
25109 Excision of tendon, forearm and/or wrist, flexor or extensor, each 30-Sep-08
25110 Excision, lesion of tendon sheath, forearm and/or wrist 30-Sep-08 3
25111 Excision of ganglion, wrist (dorsal or volar); primary 30-Sep-08 2
25112 Excision of ganglion, wrist (dorsal or volar); recurrent 30-Sep-08 2
25115 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, 30-Sep-08 2
tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors
25116 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, 30-Sep-08 2
tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis);
extensors, with or without transposition of dorsal retinaculum
25118 Synovectomy, extensor tendon sheath, wrist, single compartment; 30-Sep-08

25119 Synovectomy, extensor tendon sheath, wrist, single compartment; with 30-Sep-08 2
resection of distal ulna
25120 Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding 30-Sep-08 2
head or neck of radius and olecranon process);
head or neck of radius and olecranon process); with autograft (includes
obtaining graft)
head or neck of radius and olecranon process); with allograft
25130 Excision or curettage of bone cyst or benign tumor of carpal bones; 30-Sep-08 2
25135 Excision or curettage of bone cyst or benign tumor of carpal bones; with 30-Sep-08 2
25136 Excision or curettage of bone cyst or benign tumor of carpal bones; with allograft 30-Sep-08 2
25145 Sequestrectomy (eg, for osteomyelitis or bone abscess), forearm and/or wrist 30-Sep-08 1
25150 Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for 30-Sep-08 1
osteomyelitis); ulna
25151 Partial excision (craterization, saucerization, or diaphysectomy) of bone (eg, for 30-Sep-08 1
osteomyelitis); radius
25170 Radical resection of tumor, radius or ulna 30-Sep-08 1
25210 Carpectomy; 1 bone 30-Sep-08 2
25215 Carpectomy; all bones of proximal row 30-Sep-08 2
25230 Radial styloidectomy (separate procedure) 30-Sep-08 2
25240 Excision distal ulna partial or complete (eg, Darrach type or matched resection) 30-Sep-08 2
25246 Injection procedure for wrist arthrography 30-Sep-08 2

25248 Exploration with removal of deep foreign body, forearm or wrist 30-Sep-08 3
25250 Removal of wrist prosthesis; (separate procedure) 30-Sep-08 2
25251 Removal of wrist prosthesis; complicated, including total wrist 30-Sep-08 2
25259 Manipulation, wrist, under anesthesia 30-Sep-08 2
25260 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each 30-Sep-08
tendon or muscle
25263 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, single, each 30-Sep-08
tendon or muscle
25265 Repair, tendon or muscle, flexor, forearm and/or wrist; secondary, with free graft 30-Sep-08
(includes obtaining graft), each tendon or muscle
25270 Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each 30-Sep-08
tendon or muscle
25272 Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, single, 30-Sep-08
each tendon or muscle
25274 Repair, tendon or muscle, extensor, forearm and/or wrist; secondary, with free 30-Sep-08
graft (includes obtaining graft), each tendon or muscle
25275 Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes 30-Sep-08 2
obtaining graft) (eg, for extensor carpi ulnaris subluxation)
25280 Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, 30-Sep-08
single, each tendon
25290 Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each 30-Sep-08
tendon
25295 Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon 30-Sep-08 9
25300 Tenodesis at wrist; flexors of fingers 30-Sep-08 2

25301 Tenodesis at wrist; extensors of fingers 30-Sep-08 2
25310 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, 30-Sep-08
single; each tendon
25312 Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, 30-Sep-08
single; with tendon graft(s) (includes obtaining graft), each tendon
25315 Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or 30-Sep-08 2
wrist;
25316 Flexor origin slide (eg, for cerebral palsy, Volkmann contracture), forearm and/or 30-Sep-08 2
wrist; with tendon(s) transfer
25320 Capsulorrhaphy or reconstruction, wrist, open (eg, capsulodesis, ligament repair, 30-Sep-08 2
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 30-Sep-08 2
internal fixation
25335 Centralization of wrist on ulna (eg, radial club hand) 30-Sep-08 2
25337 Reconstruction for stabilization of unstable distal ulna or distal radioulnar joint, 30-Sep-08 2
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 30-Sep-08 2

25355 Osteotomy, radius; middle or proximal third 30-Sep-08 2
25360 Osteotomy; ulna 30-Sep-08 2
25365 Osteotomy; radius AND ulna 30-Sep-08 2
25370 Multiple osteotomies, with realignment on intramedullary rod (Sofield type 30-Sep-08 2
procedure); radius OR ulna
25375 Multiple osteotomies, with realignment on intramedullary rod (Sofield type 30-Sep-08 2
procedure); radius AND ulna
25390 Osteoplasty, radius OR ulna; shortening 30-Sep-08 2
25391 Osteoplasty, radius OR ulna; lengthening with autograft 30-Sep-08 2
25392 Osteoplasty, radius AND ulna; shortening (excluding 64876) 30-Sep-08 2
25393 Osteoplasty, radius AND ulna; lengthening with autograft 30-Sep-08 2
25394 Osteoplasty, carpal bone, shortening 30-Sep-08 2
25400 Repair of nonunion or malunion, radius OR ulna; without graft (eg, compression 30-Sep-08 2
technique)
25405 Repair of nonunion or malunion, radius OR ulna; with autograft (includes 30-Sep-08 2
obtaining graft)
25415 Repair of nonunion or malunion, radius AND ulna; without graft (eg, compression 30-Sep-08 2
technique)
25420 Repair of nonunion or malunion, radius AND ulna; with autograft (includes 30-Sep-08 2
obtaining graft)
25425 Repair of defect with autograft; radius OR ulna 30-Sep-08 2
25426 Repair of defect with autograft; radius AND ulna 30-Sep-08 2
25430 Insertion of vascular pedicle into carpal bone (eg, Hori procedure) 30-Sep-08 2
25431 Repair of nonunion of carpal bone (excluding carpal scaphoid (navicular)) 30-Sep-08 2
(includes obtaining graft and necessary fixation), each bone
25440 Repair of nonunion, scaphoid carpal (navicular) bone, with or without radial 30-Sep-08 2
styloidectomy (includes obtaining graft and necessary fixation)
25441 Arthroplasty with prosthetic replacement; distal radius 30-Sep-08 2
25442 Arthroplasty with prosthetic replacement; distal ulna 30-Sep-08 2
25443 Arthroplasty with prosthetic replacement; scaphoid carpal (navicular) 30-Sep-08 2
25444 Arthroplasty with prosthetic replacement; lunate 30-Sep-08 2
25445 Arthroplasty with prosthetic replacement; trapezium 30-Sep-08 2
25446 Arthroplasty with prosthetic replacement; distal radius and partial or entire 30-Sep-08 2
carpus (total wrist)
25447 Arthroplasty, interposition, intercarpal or carpometacarpal joints 30-Sep-08
25449 Revision of arthroplasty, including removal of implant, wrist joint 30-Sep-08 2
25450 Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna 30-Sep-08 2
25455 Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna 30-Sep-08 2
methylmethacrylate; radius
methylmethacrylate; ulna
methylmethacrylate; radius AND ulna
25500 Closed treatment of radial shaft fracture; without manipulation 30-Sep-08 2
25505 Closed treatment of radial shaft fracture; with manipulation 30-Sep-08 2
25515 Open treatment of radial shaft fracture, includes internal fixation, when 30-Sep-08 2
performed
25520 Closed treatment of radial shaft fracture and closed treatment of dislocation of 30-Sep-08 2
distal radioulnar joint (Galeazzi fracture/dislocation)
performed, and closed treatment of distal radioulnar joint dislocation (Galeazzi
fracture/ dislocation), includes percutaneous skeletal fixation, when performed
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 30-Sep-08 2
25535 Closed treatment of ulnar shaft fracture; with manipulation 30-Sep-08 2
25545 Open treatment of ulnar shaft fracture, includes internal fixation, when 30-Sep-08 2
performed
25560 Closed treatment of radial and ulnar shaft fractures; without manipulation 30-Sep-08 2
25565 Closed treatment of radial and ulnar shaft fractures; with manipulation 30-Sep-08 2
25574 Open treatment of radial AND ulnar shaft fractures, with internal fixation, when 30-Sep-08 2
performed; of radius OR ulna
25575 Open treatment of radial AND ulnar shaft fractures, with internal fixation, when 30-Sep-08 2
performed; of radius AND ulna
25600 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal 30-Sep-08 2
separation, includes closed treatment of fracture of ulnar styloid, when
performed; without manipulation
25605 Closed treatment of distal radial fracture (eg, Colles or Smith type) or epiphyseal 30-Sep-08 2
separation, includes closed treatment of fracture of ulnar styloid, when
performed; with manipulation
25606 Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation 30-Sep-08 2
25607 Open treatment of distal radial extra-articular fracture or epiphyseal separation, 30-Sep-08 2
with internal fixation
25608 Open treatment of distal radial intra-articular fracture or epiphyseal separation; 30-Sep-08 2
with internal fixation of 2 fragments
25609 Open treatment of distal radial intra-articular fracture or epiphyseal separation; 30-Sep-08 2
with internal fixation of 3 or more fragments
25622 Closed treatment of carpal scaphoid (navicular) fracture; without manipulation 30-Sep-08 2
25624 Closed treatment of carpal scaphoid (navicular) fracture; with manipulation 30-Sep-08 2
25628 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, 30-Sep-08 2
when performed
25630 Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); 30-Sep-08 2
without manipulation, each bone
25635 Closed treatment of carpal bone fracture (excluding carpal scaphoid [navicular]); 30-Sep-08 2
with manipulation, each bone
25645 Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), 30-Sep-08
each bone
25650 Closed treatment of ulnar styloid fracture 30-Sep-08 2
25651 Percutaneous skeletal fixation of ulnar styloid fracture 30-Sep-08 2
25652 Open treatment of ulnar styloid fracture 30-Sep-08 2
25660 Closed treatment of radiocarpal or intercarpal dislocation, 1 or more bones, with 30-Sep-08 2
manipulation
25670 Open treatment of radiocarpal or intercarpal dislocation, 1 or more bones 30-Sep-08 2
25671 Percutaneous skeletal fixation of distal radioulnar dislocation 30-Sep-08 2

25675 Closed treatment of distal radioulnar dislocation with manipulation 30-Sep-08 2
25676 Open treatment of distal radioulnar dislocation, acute or chronic 30-Sep-08 2
25680 Closed treatment of trans-scaphoperilunar type of fracture dislocation, with 30-Sep-08 2
manipulation
25685 Open treatment of trans-scaphoperilunar type of fracture dislocation 30-Sep-08 2
25690 Closed treatment of lunate dislocation, with manipulation 30-Sep-08 2
25695 Open treatment of lunate dislocation 30-Sep-08 2
25800 Arthrodesis, wrist; complete, without bone graft (includes radiocarpal and/or 30-Sep-08 2
intercarpal and/or carpometacarpal joints)
25805 Arthrodesis, wrist; with sliding graft 30-Sep-08 2
25810 Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) 30-Sep-08 2
25820 Arthrodesis, wrist; limited, without bone graft (eg, intercarpal or radiocarpal) 30-Sep-08 2
25825 Arthrodesis, wrist; with autograft (includes obtaining graft) 30-Sep-08 2

25830 Arthrodesis, distal radioulnar joint with segmental resection of ulna, with or 30-Sep-08 2
without bone graft (eg, Sauve-Kapandji procedure)
25900 Amputation, forearm, through radius and ulna; 30-Sep-08 2
25905 Amputation, forearm, through radius and ulna; open, circular (guillotine) 30-Sep-08 2
25907 Amputation, forearm, through radius and ulna; secondary closure or scar revision 30-Sep-08 2
25909 Amputation, forearm, through radius and ulna; re-amputation 30-Sep-08 2

25915 Krukenberg procedure 30-Sep-08 2
25920 Disarticulation through wrist; 30-Sep-08 2
25922 Disarticulation through wrist; secondary closure or scar revision 30-Sep-08 2
25924 Disarticulation through wrist; re-amputation 30-Sep-08 2
25927 Transmetacarpal amputation; 30-Sep-08 2
25929 Transmetacarpal amputation; secondary closure or scar revision 30-Sep-08 2
25931 Transmetacarpal amputation; re-amputation 30-Sep-08 2
25999 Unlisted procedure, forearm or wrist 30-Sep-08
26010 Drainage of finger abscess; simple 30-Sep-08 3

26011 Drainage of finger abscess; complicated (eg, felon) 30-Sep-08 3
26020 Drainage of tendon sheath, digit and/or palm, each 30-Sep-08
26025 Drainage of palmar bursa; single, bursa 30-Sep-08 2
26030 Drainage of palmar bursa; multiple bursa 30-Sep-08 2
26034 Incision, bone cortex, hand or finger (eg, osteomyelitis or bone abscess) 30-Sep-08 2
26035 Decompression fingers and/or hand, injection injury (eg, grease gun) 30-Sep-08 3
26037 Decompressive fasciotomy, hand (excludes 26035) 30-Sep-08 2
26040 Fasciotomy, palmar (eg, Dupuytren's contracture); percutaneous 30-Sep-08 2
26045 Fasciotomy, palmar (eg, Dupuytren's contracture); open, partial 30-Sep-08 2
26055 Tendon sheath incision (eg, for trigger finger) 30-Sep-08
26060 Tenotomy, percutaneous, single, each digit 30-Sep-08
26070 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; 30-Sep-08 3
carpometacarpal joint
26075 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; 30-Sep-08
metacarpophalangeal joint, each
26080 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; 30-Sep-08
interphalangeal joint, each
26100 Arthrotomy with biopsy; carpometacarpal joint, each 30-Sep-08 2
26105 Arthrotomy with biopsy; metacarpophalangeal joint, each 30-Sep-08 2
26110 Arthrotomy with biopsy; interphalangeal joint, each 30-Sep-08 3
26111 Excision, tumor or vascular malformation, soft tissue of hand or finger, 15-Oct-12
subcutaneous; 1.5 cm or greater
26113 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, 15-Oct-12
subfascial (eg, intramuscular); 1.5 cm or greater
26115 Excision, tumor or vascular malformation, soft tissue of hand or finger, 30-Sep-08
subcutaneous; less than 1.5 cm
26116 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, 30-Sep-08
subfascial (eg, intramuscular); less than 1.5 cm
26117 Radical resection of tumor (eg, malignant neoplasm), soft tissue of hand or 30-Sep-08 2
finger; less than 3 cm
26118 Radical resection of tumor (eg, malignant neoplasm), soft tissue of hand or 15-Oct-12
finger; 3 cm or greater
26121 Fasciectomy, palm only, with or without Z-plasty, other local tissue 30-Sep-08 2
rearrangement, or skin grafting (includes obtaining graft)
26123 Fasciectomy, partial palmar with release of single digit including proximal 30-Sep-08 2
interphalangeal joint, with or without Z-plasty, other local tissue rearrangement,
or skin grafting (includes obtaining graft);
26125 Fasciectomy, partial palmar with release of single digit including proximal 30-Sep-08
interphalangeal joint, with or without Z-plasty, other local tissue rearrangement,
or skin grafting (includes obtaining graft); each additional digit (List separately in
26130 Synovectomy, carpometacarpal joint 30-Sep-08

26135 Synovectomy, metacarpophalangeal joint including intrinsic release and 30-Sep-08
extensor hood reconstruction, each digit
26140 Synovectomy, proximal interphalangeal joint, including extensor reconstruction, 30-Sep-08
each interphalangeal joint
26145 Synovectomy, tendon sheath, radical (tenosynovectomy), flexor tendon, palm 30-Sep-08
and/or finger, each tendon
26160 Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or 30-Sep-08
ganglion), hand or finger
26170 Excision of tendon, palm, flexor or extensor, single, each tendon 30-Sep-08
26180 Excision of tendon, finger, flexor or extensor, each tendon 30-Sep-08
26185 Sesamoidectomy, thumb or finger (separate procedure) 30-Sep-08 1
26200 Excision or curettage of bone cyst or benign tumor of metacarpal; 30-Sep-08
26205 Excision or curettage of bone cyst or benign tumor of metacarpal; with autograft 30-Sep-08 2
26210 Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal 30-Sep-08
phalanx of finger;
26215 Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal 30-Sep-08 2
phalanx of finger; with autograft (includes obtaining graft)

osteomyelitis); metacarpal
26235 Partial excision (craterization, saucerization, or diaphysectomy) bone (eg, 30-Sep-08
osteomyelitis); proximal or middle phalanx of finger
osteomyelitis); distal phalanx of finger
26250 Radical resection of tumor, metacarpal 30-Sep-08 2
26255 Radical resection, metacarpal (eg, tumor); with autograft (includes obtaining 30-Sep-08 14-Oct-12
graft)
26260 Radical resection of tumor, proximal or middle phalanx of finger 30-Sep-08 2
26261 Radical resection, proximal or middle phalanx of finger (eg, tumor); with 30-Sep-08 14-Oct-12
26262 Radical resection of tumor, distal phalanx of finger 30-Sep-08 2
26320 Removal of implant from finger or hand 30-Sep-08
26340 Manipulation, finger joint, under anesthesia, each joint 30-Sep-08
26350 Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath 30-Sep-08
(eg, no man's land); primary or secondary without free graft, each tendon
26352 Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath 30-Sep-08
(eg, no man's land); secondary with free graft (includes obtaining graft), each
tendon
26356 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, 30-Sep-08
no man's land); primary, without free graft, each tendon
26357 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, 30-Sep-08 3
no man's land); secondary, without free graft, each tendon
26358 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (eg, 30-Sep-08 3
no man's land); secondary, with free graft (includes obtaining graft), each
tendon
26370 Repair or advancement of profundus tendon, with intact superficialis tendon; 30-Sep-08
primary, each tendon
secondary with free graft (includes obtaining graft), each tendon
secondary without free graft, each tendon
26390 Excision flexor tendon, with implantation of synthetic rod for delayed tendon 30-Sep-08 3
graft, hand or finger, each rod
26392 Removal of synthetic rod and insertion of flexor tendon graft, hand or finger 30-Sep-08 3
(includes obtaining graft), each rod
26410 Repair, extensor tendon, hand, primary or secondary; without free graft, each 30-Sep-08
tendon
26412 Repair, extensor tendon, hand, primary or secondary; with free graft (includes 30-Sep-08
obtaining graft), each tendon
26415 Excision of extensor tendon, with implantation of synthetic rod for delayed 30-Sep-08
tendon graft, hand or finger, each rod
26416 Removal of synthetic rod and insertion of extensor tendon graft (includes 30-Sep-08 2
obtaining graft), hand or finger, each rod
26418 Repair, extensor tendon, finger, primary or secondary; without free graft, each 30-Sep-08
tendon
26420 Repair, extensor tendon, finger, primary or secondary; with free graft (includes 30-Sep-08
obtaining graft) each tendon
26426 Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); 30-Sep-08
using local tissue(s), including lateral band(s), each finger
26428 Repair of extensor tendon, central slip, secondary (eg, boutonniere deformity); 30-Sep-08 2
with free graft (includes obtaining graft), each finger
26432 Closed treatment of distal extensor tendon insertion, with or without 30-Sep-08 2
percutaneous pinning (eg, mallet finger)
26433 Repair of extensor tendon, distal insertion, primary or secondary; without graft 30-Sep-08 2
(eg, mallet finger)
26434 Repair of extensor tendon, distal insertion, primary or secondary; with free graft 30-Sep-08 3
26437 Realignment of extensor tendon, hand, each tendon 30-Sep-08
26440 Tenolysis, flexor tendon; palm OR finger, each tendon 30-Sep-08
26442 Tenolysis, flexor tendon; palm AND finger, each tendon 30-Sep-08
26445 Tenolysis, extensor tendon, hand OR finger, each tendon 30-Sep-08
26449 Tenolysis, complex, extensor tendon, finger, including forearm, each tendon 30-Sep-08
26450 Tenotomy, flexor, palm, open, each tendon 30-Sep-08

26455 Tenotomy, flexor, finger, open, each tendon 30-Sep-08
26460 Tenotomy, extensor, hand or finger, open, each tendon 30-Sep-08
26471 Tenodesis; of proximal interphalangeal joint, each joint 30-Sep-08
26474 Tenodesis; of distal joint, each joint 30-Sep-08
26476 Lengthening of tendon, extensor, hand or finger, each tendon 30-Sep-08
26477 Shortening of tendon, extensor, hand or finger, each tendon 30-Sep-08
26478 Lengthening of tendon, flexor, hand or finger, each tendon 30-Sep-08
26479 Shortening of tendon, flexor, hand or finger, each tendon 30-Sep-08
26480 Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; 30-Sep-08
without free graft, each tendon
26483 Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; with 30-Sep-08
free tendon graft (includes obtaining graft), each tendon
26485 Transfer or transplant of tendon, palmar; without free tendon graft, each tendon 30-Sep-08
26489 Transfer or transplant of tendon, palmar; with free tendon graft (includes 30-Sep-08
obtaining graft), each tendon
26490 Opponensplasty; superficialis tendon transfer type, each tendon 30-Sep-08
26492 Opponensplasty; tendon transfer with graft (includes obtaining graft), each 30-Sep-08
tendon
26494 Opponensplasty; hypothenar muscle transfer 30-Sep-08 2
26496 Opponensplasty; other methods 30-Sep-08 2
26497 Transfer of tendon to restore intrinsic function; ring and small finger 30-Sep-08 2
26498 Transfer of tendon to restore intrinsic function; all 4 fingers 30-Sep-08 2
26499 Correction claw finger, other methods 30-Sep-08
26500 Reconstruction of tendon pulley, each tendon; with local tissues (separate 30-Sep-08
procedure)
26502 Reconstruction of tendon pulley, each tendon; with tendon or fascial graft 30-Sep-08
(includes obtaining graft) (separate procedure)
26508 Release of thenar muscle(s) (eg, thumb contracture) 30-Sep-08 2
26510 Cross intrinsic transfer, each tendon 30-Sep-08
26516 Capsulodesis, metacarpophalangeal joint; single digit 30-Sep-08 2
26517 Capsulodesis, metacarpophalangeal joint; 2 digits 30-Sep-08 2
26518 Capsulodesis, metacarpophalangeal joint; 3 or 4 digits 30-Sep-08 2
26520 Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint 30-Sep-08
26525 Capsulectomy or capsulotomy; interphalangeal joint, each joint 30-Sep-08
26530 Arthroplasty, metacarpophalangeal joint; each joint 30-Sep-08
26531 Arthroplasty, metacarpophalangeal joint; with prosthetic implant, each joint 30-Sep-08
26535 Arthroplasty, interphalangeal joint; each joint 30-Sep-08

26536 Arthroplasty, interphalangeal joint; with prosthetic implant, each joint 30-Sep-08
26540 Repair of collateral ligament, metacarpophalangeal or interphalangeal joint 30-Sep-08
26541 Reconstruction, collateral ligament, metacarpophalangeal joint, single; with 30-Sep-08

tendon or fascial graft (includes obtaining graft)
26542 Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local 30-Sep-08
tissue (eg, adductor advancement)
26545 Reconstruction, collateral ligament, interphalangeal joint, single, including graft, 30-Sep-08
each joint
26546 Repair non-union, metacarpal or phalanx (includes obtaining bone graft with or 30-Sep-08
without external or internal fixation)
26548 Repair and reconstruction, finger, volar plate, interphalangeal joint 30-Sep-08 3
26550 Pollicization of a digit 30-Sep-08 2
26551 Transfer, toe-to-hand with microvascular anastomosis; great toe wrap-around 30-Sep-08 2
with bone graft
26553 Transfer, toe-to-hand with microvascular anastomosis; other than great toe, 30-Sep-08 2
single
26554 Transfer, toe-to-hand with microvascular anastomosis; other than great toe, 30-Sep-08 2
double
26555 Transfer, finger to another position without microvascular anastomosis 30-Sep-08 2
26556 Transfer, free toe joint, with microvascular anastomosis 30-Sep-08 2

26560 Repair of syndactyly (web finger) each web space; with skin flaps 30-Sep-08 2
26561 Repair of syndactyly (web finger) each web space; with skin flaps and grafts 30-Sep-08 2
26562 Repair of syndactyly (web finger) each web space; complex (eg, involving bone, 30-Sep-08 2
nails)
26565 Osteotomy; metacarpal, each 30-Sep-08
26567 Osteotomy; phalanx of finger, each 30-Sep-08
26568 Osteoplasty, lengthening, metacarpal or phalanx 30-Sep-08
26580 Repair cleft hand 30-Sep-08 2
26587 Reconstruction of polydactylous digit, soft tissue and bone 30-Sep-08
26590 Repair macrodactylia, each digit 30-Sep-08
26591 Repair, intrinsic muscles of hand, each muscle 30-Sep-08
26593 Release, intrinsic muscles of hand, each muscle 30-Sep-08
26596 Excision of constricting ring of finger, with multiple Z-plasties 30-Sep-08
26600 Closed treatment of metacarpal fracture, single; without manipulation, each 30-Sep-08
bone
26605 Closed treatment of metacarpal fracture, single; with manipulation, each bone 30-Sep-08
26607 Closed treatment of metacarpal fracture, with manipulation, with external 30-Sep-08
fixation, each bone
26608 Percutaneous skeletal fixation of metacarpal fracture, each bone 30-Sep-08
26615 Open treatment of metacarpal fracture, single, includes internal fixation, when 30-Sep-08
performed, each bone
26641 Closed treatment of carpometacarpal dislocation, thumb, with manipulation 30-Sep-08 2
26645 Closed treatment of carpometacarpal fracture dislocation, thumb (Bennett 30-Sep-08 2

fracture), with manipulation
26650 Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb 30-Sep-08 2
(Bennett fracture), with manipulation
26665 Open treatment of carpometacarpal fracture dislocation, thumb (Bennett 30-Sep-08 2
fracture), includes internal fixation, when performed
26670 Closed treatment of carpometacarpal dislocation, other than thumb, with 30-Sep-08
manipulation, each joint; without anesthesia
26675 Closed treatment of carpometacarpal dislocation, other than thumb, with 30-Sep-08
manipulation, each joint; requiring anesthesia
26676 Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, 30-Sep-08
with manipulation, each joint
26685 Open treatment of carpometacarpal dislocation, other than thumb; includes 30-Sep-08
internal fixation, when performed, each joint
26686 Open treatment of carpometacarpal dislocation, other than thumb; complex, 30-Sep-08
multiple, or delayed reduction
26700 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; 30-Sep-08
without anesthesia
26705 Closed treatment of metacarpophalangeal dislocation, single, with manipulation; 30-Sep-08
requiring anesthesia
26706 Percutaneous skeletal fixation of metacarpophalangeal dislocation, single, with 30-Sep-08
manipulation
26715 Open treatment of metacarpophalangeal dislocation, single, includes internal 30-Sep-08
26720 Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, 30-Sep-08
finger or thumb; without manipulation, each
26725 Closed treatment of phalangeal shaft fracture, proximal or middle phalanx, 30-Sep-08
finger or thumb; with manipulation, with or without skin or skeletal traction, each
26727 Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or 30-Sep-08
middle phalanx, finger or thumb, with manipulation, each
26735 Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger 30-Sep-08
or thumb, includes internal fixation, when performed, each
26740 Closed treatment of articular fracture, involving metacarpophalangeal or 30-Sep-08 3

interphalangeal joint; without manipulation, each
26742 Closed treatment of articular fracture, involving metacarpophalangeal or 30-Sep-08 3
interphalangeal joint; with manipulation, each
26746 Open treatment of articular fracture, involving metacarpophalangeal or 30-Sep-08 3
interphalangeal joint, includes internal fixation, when performed, each
26750 Closed treatment of distal phalangeal fracture, finger or thumb; without 30-Sep-08
manipulation, each
26755 Closed treatment of distal phalangeal fracture, finger or thumb; with 30-Sep-08
manipulation, each
26756 Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, 30-Sep-08
each
26765 Open treatment of distal phalangeal fracture, finger or thumb, includes internal 30-Sep-08
fixation, when performed, each
26770 Closed treatment of interphalangeal joint dislocation, single, with manipulation; 30-Sep-08
without anesthesia
26775 Closed treatment of interphalangeal joint dislocation, single, with manipulation; 30-Sep-08
requiring anesthesia
26776 Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with 30-Sep-08
manipulation
26785 Open treatment of interphalangeal joint dislocation, includes internal fixation, 30-Sep-08
when performed, single
26820 Fusion in opposition, thumb, with autogenous graft (includes obtaining graft) 30-Sep-08 2
26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; 30-Sep-08 2
26842 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with 30-Sep-08 2
26843 Arthrodesis, carpometacarpal joint, digit, other than thumb, each; 30-Sep-08
26844 Arthrodesis, carpometacarpal joint, digit, other than thumb, each; with autograft 30-Sep-08
26850 Arthrodesis, metacarpophalangeal joint, with or without internal fixation; 30-Sep-08
26852 Arthrodesis, metacarpophalangeal joint, with or without internal fixation; with 30-Sep-08
26860 Arthrodesis, interphalangeal joint, with or without internal fixation; 30-Sep-08 1
26861 Arthrodesis, interphalangeal joint, with or without internal fixation; each 30-Sep-08
additional interphalangeal joint (List separately in addition to code for primary
procedure)
26862 Arthrodesis, interphalangeal joint, with or without internal fixation; with 30-Sep-08 1
26863 Arthrodesis, interphalangeal joint, with or without internal fixation; with 30-Sep-08
autograft (includes obtaining graft), each additional joint (List separately in
26910 Amputation, metacarpal, with finger or thumb (ray amputation), single, with or 30-Sep-08
without interosseous transfer
26951 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, 30-Sep-08
including neurectomies; with direct closure
26952 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, 30-Sep-08
including neurectomies; with local advancement flaps (V-Y, hood)
26989 Unlisted procedure, hands or fingers 30-Sep-08
26990 Incision and drainage, pelvis or hip joint area; deep abscess or hematoma 30-Sep-08 2
26991 Incision and drainage, pelvis or hip joint area; infected bursa 30-Sep-08 2
26992 Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or bone abscess) 30-Sep-08 2
27000 Tenotomy, adductor of hip, percutaneous (separate procedure) 30-Sep-08 2

27001 Tenotomy, adductor of hip, open 30-Sep-08 1
27003 Tenotomy, adductor, subcutaneous, open, with obturator neurectomy 30-Sep-08 1
27005 Tenotomy, hip flexor(s), open (separate procedure) 30-Sep-08 2

27006 Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure) 30-Sep-08 2
27025 Fasciotomy, hip or thigh, any type 30-Sep-08 1

27027 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus 15-Oct-12 1
medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle),
unilateral
27030 Arthrotomy, hip, with drainage (eg, infection) 30-Sep-08 2
27033 Arthrotomy, hip, including exploration or removal of loose or foreign body 30-Sep-08 2
27035 Denervation, hip joint, intrapelvic or extrapelvic intra-articular branches of 30-Sep-08 2

sciatic, femoral, or obturator nerves
27036 Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, 30-Sep-08 2
with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor
fascia latae, rectus femoris, sartorius, iliopsoas)
27040 Biopsy, soft tissue of pelvis and hip area; superficial 30-Sep-08 2
27041 Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular 30-Sep-08 3
27043 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater 15-Oct-12
27045 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 15-Oct-12
5 cm or greater
27047 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm 30-Sep-08
27048 Excision, tumor, soft tissue of pelvis and hip area, subfascial (eg, intramuscular); 30-Sep-08 2
less than 5 cm
27049 Radical resection of tumor (eg, malignant neoplasm), soft tissue of pelvis and hip 30-Sep-08 2
27050 Arthrotomy, with biopsy; sacroiliac joint 30-Sep-08 2
27052 Arthrotomy, with biopsy; hip joint 30-Sep-08 2
27054 Arthrotomy with synovectomy, hip joint 30-Sep-08 2
27057 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus 15-Oct-12 1
medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle)
with debridement of nonviable muscle, unilateral
27059 Radical resection of tumor (eg, malignant neoplasm), soft tissue of pelvis and hip 15-Oct-12
27060 Excision; ischial bursa 30-Sep-08 2
27062 Excision; trochanteric bursa or calcification 30-Sep-08 2
27065 Excision of bone cyst or benign tumor, wing of ilium, symphysis pubis, or greater 30-Sep-08 2
trochanter of femur; superficial, includes autograft, when performed
trochanter of femur; deep (subfascial), includes autograft, when performed
trochanter of femur; with autograft requiring separate incision
27070 Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, 30-Sep-08 2
(craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial
27071 Partial excision, wing of ilium, symphysis pubis, or greater trochanter of femur, 30-Sep-08 2
(craterization, saucerization) (eg, osteomyelitis or bone abscess); deep
(subfascial or intramuscular)
27075 Radical resection of tumor; wing of ilium, 1 pubic or ischial ramus or symphysis 30-Sep-08 1
pubis
27076 Radical resection of tumor; ilium, including acetabulum, both pubic rami, or 30-Sep-08 2
ischium and acetabulum
27077 Radical resection of tumor; innominate bone, total 30-Sep-08 2
27078 Radical resection of tumor; ischial tuberosity and greater trochanter of femur 30-Sep-08 2
27079 Radical resection of tumor or infection; ischial tuberosity and greater trochanter 30-Sep-08 14-Oct-12
of femur, with skin flaps
27080 Coccygectomy, primary 30-Sep-08 1
27086 Removal of foreign body, pelvis or hip; subcutaneous tissue 30-Sep-08 2
27087 Removal of foreign body, pelvis or hip; deep (subfascial or intramuscular) 30-Sep-08 2
27090 Removal of hip prosthesis; (separate procedure) 30-Sep-08 2

27091 Removal of hip prosthesis; complicated, including total hip prosthesis, 30-Sep-08 2
methylmethacrylate with or without insertion of spacer
27093 Injection procedure for hip arthrography; without anesthesia 30-Sep-08 2
27095 Injection procedure for hip arthrography; with anesthesia 30-Sep-08 2
27096 Injection procedure for sacroiliac joint, arthrography and/or anesthetic/steroid 30-Sep-08 1
27097 Release or recession, hamstring, proximal 30-Sep-08 2

27098 Transfer, adductor to ischium 30-Sep-08 2
27100 Transfer external oblique muscle to greater trochanter including fascial or tendon 30-Sep-08 2
extension (graft)
27105 Transfer paraspinal muscle to hip (includes fascial or tendon extension graft) 30-Sep-08 2
27110 Transfer iliopsoas; to greater trochanter of femur 30-Sep-08 2

27111 Transfer iliopsoas; to femoral neck 30-Sep-08 2
27120 Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) 30-Sep-08 2
27122 Acetabuloplasty; resection, femoral head (eg, Girdlestone procedure) 30-Sep-08 2
27125 Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty) 30-Sep-08 2
27130 Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip 30-Sep-08 2
arthroplasty), with or without autograft or allograft
27132 Conversion of previous hip surgery to total hip arthroplasty, with or without 30-Sep-08 2
autograft or allograft
27134 Revision of total hip arthroplasty; both components, with or without autograft or 30-Sep-08 2
allograft
27137 Revision of total hip arthroplasty; acetabular component only, with or without 30-Sep-08 2
autograft or allograft
27138 Revision of total hip arthroplasty; femoral component only, with or without 30-Sep-08 2
allograft
27140 Osteotomy and transfer of greater trochanter of femur (separate procedure) 30-Sep-08 2
27146 Osteotomy, iliac, acetabular or innominate bone; 30-Sep-08 2

27147 Osteotomy, iliac, acetabular or innominate bone; with open reduction of hip 30-Sep-08 2
27151 Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy 30-Sep-08 2
27156 Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy and 30-Sep-08 2
with open reduction of hip
27158 Osteotomy, pelvis, bilateral (eg, congenital malformation) 30-Sep-08 1
27161 Osteotomy, femoral neck (separate procedure) 30-Sep-08 2
27165 Osteotomy, intertrochanteric or subtrochanteric including internal or external 30-Sep-08 2
fixation and/or cast
27170 Bone graft, femoral head, neck, intertrochanteric or subtrochanteric area 30-Sep-08 2
(includes obtaining bone graft)
27175 Treatment of slipped femoral epiphysis; by traction, without reduction 30-Sep-08 2
27176 Treatment of slipped femoral epiphysis; by single or multiple pinning, in situ 30-Sep-08 2
27177 Open treatment of slipped femoral epiphysis; single or multiple pinning or bone 30-Sep-08 2
27178 Open treatment of slipped femoral epiphysis; closed manipulation with single or 30-Sep-08 2
multiple pinning
27179 Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck 30-Sep-08 2
(Heyman type procedure)
27181 Open treatment of slipped femoral epiphysis; osteotomy and internal fixation 30-Sep-08 2
27185 Epiphyseal arrest by epiphysiodesis or stapling, greater trochanter of femur 30-Sep-08 2
methylmethacrylate, femoral neck and proximal femur
27193 Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; 30-Sep-08 1
27194 Closed treatment of pelvic ring fracture, dislocation, diastasis or subluxation; 30-Sep-08 1
with manipulation, requiring more than local anesthesia
27200 Closed treatment of coccygeal fracture 30-Sep-08 1
27202 Open treatment of coccygeal fracture 30-Sep-08 1
27215 Open treatment of iliac spine(s), tuberosity avulsion, or iliac wing fracture(s), 30-Sep-08
unilateral, for pelvic bone fracture patterns that do not disrupt the pelvic ring,
includes internal fixation, when performed
27216 Percutaneous skeletal fixation of posterior pelvic bone fracture and/or 30-Sep-08
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 30-Sep-08
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 30-Sep-08
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 30-Sep-08 2
27222 Closed treatment of acetabulum (hip socket) fracture(s); with manipulation, with 30-Sep-08 2
or without skeletal traction
27226 Open treatment of posterior or anterior acetabular wall fracture, with internal 30-Sep-08 2
fixation
27227 Open treatment of acetabular fracture(s) involving anterior or posterior (one) 30-Sep-08 2
column, or a fracture running transversely across the acetabulum, with internal
fixation
27228 Open treatment of acetabular fracture(s) involving anterior and posterior (two) 30-Sep-08 2
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 30-Sep-08 2
27232 Closed treatment of femoral fracture, proximal end, neck; with manipulation, 30-Sep-08 2
with or without skeletal traction
27235 Percutaneous skeletal fixation of femoral fracture, proximal end, neck 30-Sep-08 2
27236 Open treatment of femoral fracture, proximal end, neck, internal fixation or 30-Sep-08 2
prosthetic replacement
27238 Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric 30-Sep-08 2
femoral fracture; without manipulation
27240 Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric 30-Sep-08 2
femoral fracture; with manipulation, with or without skin or skeletal traction
27244 Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral 30-Sep-08 2

fracture; with plate/screw type implant, with or without cerclage
27245 Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral 30-Sep-08 2

fracture; with intramedullary implant, with or without interlocking screws and/or
cerclage
27246 Closed treatment of greater trochanteric fracture, without manipulation 30-Sep-08 2
27248 Open treatment of greater trochanteric fracture, includes internal fixation, when 30-Sep-08 2
performed
27250 Closed treatment of hip dislocation, traumatic; without anesthesia 30-Sep-08 2
27252 Closed treatment of hip dislocation, traumatic; requiring anesthesia 30-Sep-08 2
27253 Open treatment of hip dislocation, traumatic, without internal fixation 30-Sep-08 2
27254 Open treatment of hip dislocation, traumatic, with acetabular wall and femoral 30-Sep-08 2
head fracture, with or without internal or external fixation
27256 Treatment of spontaneous hip dislocation (developmental, including congenital 30-Sep-08 2

or pathological), by abduction, splint or traction; without anesthesia, without
manipulation
27257 Treatment of spontaneous hip dislocation (developmental, including congenital 30-Sep-08 2
or pathological), by abduction, splint or traction; with manipulation, requiring
anesthesia
27258 Open treatment of spontaneous hip dislocation (developmental, including 30-Sep-08 2
congenital or pathological), replacement of femoral head in acetabulum
(including tenotomy, etc);
27259 Open treatment of spontaneous hip dislocation (developmental, including 30-Sep-08 2
congenital or pathological), replacement of femoral head in acetabulum
(including tenotomy, etc); with femoral shaft shortening
27265 Closed treatment of post hip arthroplasty dislocation; without anesthesia 30-Sep-08 2
27266 Closed treatment of post hip arthroplasty dislocation; requiring regional or 30-Sep-08 2
general anesthesia
27267 Closed treatment of femoral fracture, proximal end, head; without manipulation 30-Sep-08 2
27268 Closed treatment of femoral fracture, proximal end, head; with manipulation 30-Sep-08 2
27269 Open treatment of femoral fracture, proximal end, head, includes internal 30-Sep-08 2
27275 Manipulation, hip joint, requiring general anesthesia 30-Sep-08 2
27280 Arthrodesis, sacroiliac joint (including obtaining graft) 30-Sep-08 1
27282 Arthrodesis, symphysis pubis (including obtaining graft) 30-Sep-08 1
27284 Arthrodesis, hip joint (including obtaining graft); 30-Sep-08 2
27286 Arthrodesis, hip joint (including obtaining graft); with subtrochanteric osteotomy 30-Sep-08 2
27290 Interpelviabdominal amputation (hindquarter amputation) 30-Sep-08 1

27295 Disarticulation of hip 30-Sep-08 2
27299 Unlisted procedure, pelvis or hip joint 30-Sep-08
27301 Incision and drainage, deep abscess, bursa, or hematoma, thigh or knee region 30-Sep-08
27303 Incision, deep, with opening of bone cortex, femur or knee (eg, osteomyelitis or 30-Sep-08 2
bone abscess)
27305 Fasciotomy, iliotibial (tenotomy), open 30-Sep-08 2
27306 Tenotomy, percutaneous, adductor or hamstring; single tendon (separate 30-Sep-08 2
procedure)
27307 Tenotomy, percutaneous, adductor or hamstring; multiple tendons 30-Sep-08 2
27310 Arthrotomy, knee, with exploration, drainage, or removal of foreign body (eg, 30-Sep-08 2
infection)
27323 Biopsy, soft tissue of thigh or knee area; superficial 30-Sep-08
27324 Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular) 30-Sep-08
27325 Neurectomy, hamstring muscle 30-Sep-08 1

27326 Neurectomy, popliteal (gastrocnemius) 30-Sep-08 1
27327 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm 30-Sep-08
27328 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 30-Sep-08
less than 5 cm
27329 Radical resection of tumor (eg, malignant neoplasm), soft tissue of thigh or knee 30-Sep-08 2
27330 Arthrotomy, knee; with synovial biopsy only 30-Sep-08 2
27331 Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or 30-Sep-08 2
foreign bodies
27332 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial 30-Sep-08 2
OR lateral
27333 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial 30-Sep-08 2
AND lateral
27334 Arthrotomy, with synovectomy, knee; anterior OR posterior 30-Sep-08 2
27335 Arthrotomy, with synovectomy, knee; anterior AND posterior including popliteal 30-Sep-08 2
area
27337 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater 15-Oct-12
27339 Excision, tumor, soft tissue of thigh or knee area, subfascial (eg, intramuscular); 15-Oct-12
5 cm or greater
27340 Excision, prepatellar bursa 30-Sep-08 2
27345 Excision of synovial cyst of popliteal space (eg, Baker's cyst) 30-Sep-08 2
27347 Excision of lesion of meniscus or capsule (eg, cyst, ganglion), knee 30-Sep-08 2
27350 Patellectomy or hemipatellectomy 30-Sep-08 2
27355 Excision or curettage of bone cyst or benign tumor of femur; 30-Sep-08 2
27356 Excision or curettage of bone cyst or benign tumor of femur; with allograft 30-Sep-08 2
27357 Excision or curettage of bone cyst or benign tumor of femur; with autograft 30-Sep-08 2
27358 Excision or curettage of bone cyst or benign tumor of femur; with internal 30-Sep-08 2
fixation (List in addition to code for primary procedure)
27360 Partial excision (craterization, saucerization, or diaphysectomy) bone, femur, 30-Sep-08
proximal tibia and/or fibula (eg, osteomyelitis or bone abscess)
27364 Radical resection of tumor (eg, malignant neoplasm), soft tissue of thigh or knee 15-Oct-12
27365 Radical resection of tumor, femur or knee 30-Sep-08 2
27370 Injection procedure for knee arthrography 30-Sep-08 2
27372 Removal of foreign body, deep, thigh region or knee area 30-Sep-08
27380 Suture of infrapatellar tendon; primary 30-Sep-08 2
27381 Suture of infrapatellar tendon; secondary reconstruction, including fascial or 30-Sep-08 2
tendon graft
27385 Suture of quadriceps or hamstring muscle rupture; primary 30-Sep-08 2
27386 Suture of quadriceps or hamstring muscle rupture; secondary reconstruction, 30-Sep-08 2
including fascial or tendon graft
27390 Tenotomy, open, hamstring, knee to hip; single tendon 30-Sep-08 2
27391 Tenotomy, open, hamstring, knee to hip; multiple tendons, 1 leg 30-Sep-08 1
27392 Tenotomy, open, hamstring, knee to hip; multiple tendons, bilateral 30-Sep-08 1
27393 Lengthening of hamstring tendon; single tendon 30-Sep-08 2
27394 Lengthening of hamstring tendon; multiple tendons, 1 leg 30-Sep-08 1
27395 Lengthening of hamstring tendon; multiple tendons, bilateral 30-Sep-08 1
27396 Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor 30-Sep-08 2
to flexor); single tendon
27397 Transplant or transfer (with muscle redirection or rerouting), thigh (eg, extensor 30-Sep-08 2
to flexor); multiple tendons
27400 Transfer, tendon or muscle, hamstrings to femur (eg, Egger's type procedure) 30-Sep-08 2
27403 Arthrotomy with meniscus repair, knee 30-Sep-08 2

27405 Repair, primary, torn ligament and/or capsule, knee; collateral 30-Sep-08 2
27407 Repair, primary, torn ligament and/or capsule, knee; cruciate 30-Sep-08 2
27409 Repair, primary, torn ligament and/or capsule, knee; collateral and cruciate 30-Sep-08 2
ligaments
27412 Autologous chondrocyte implantation, knee 30-Sep-08 2
27415 Osteochondral allograft, knee, open 30-Sep-08 2
27416 Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting 30-Sep-08 2
of autograft[s])
27418 Anterior tibial tubercleplasty (eg, Maquet type procedure) 30-Sep-08 2
27420 Reconstruction of dislocating patella; (eg, Hauser type procedure) 30-Sep-08 2
27422 Reconstruction of dislocating patella; with extensor realignment and/or muscle 30-Sep-08 2
advancement or release (eg, Campbell, Goldwaite type procedure)
27424 Reconstruction of dislocating patella; with patellectomy 30-Sep-08 2

27425 Lateral retinacular release, open 30-Sep-08 2
27427 Ligamentous reconstruction (augmentation), knee; extra-articular 30-Sep-08 2
27428 Ligamentous reconstruction (augmentation), knee; intra-articular (open) 30-Sep-08 2
27429 Ligamentous reconstruction (augmentation), knee; intra-articular (open) and 30-Sep-08 2

extra-articular
27430 Quadricepsplasty (eg, Bennett or Thompson type) 30-Sep-08 2
27435 Capsulotomy, posterior capsular release, knee 30-Sep-08 2
27437 Arthroplasty, patella; without prosthesis 30-Sep-08 2
27438 Arthroplasty, patella; with prosthesis 30-Sep-08 2
27440 Arthroplasty, knee, tibial plateau; 30-Sep-08 2
27441 Arthroplasty, knee, tibial plateau; with debridement and partial synovectomy 30-Sep-08 2
27442 Arthroplasty, femoral condyles or tibial plateau(s), knee; 30-Sep-08 2

27443 Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and 30-Sep-08 2
partial synovectomy
27445 Arthroplasty, knee, hinge prosthesis (eg, Walldius type) 30-Sep-08 2
27446 Arthroplasty, knee, condyle and plateau; medial OR lateral compartment 30-Sep-08 2
27447 Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with 30-Sep-08 2
or without patella resurfacing (total knee arthroplasty)
27448 Osteotomy, femur, shaft or supracondylar; without fixation 30-Sep-08 1

27450 Osteotomy, femur, shaft or supracondylar; with fixation 30-Sep-08 1
27454 Osteotomy, multiple, with realignment on intramedullary rod, femoral shaft (eg, 30-Sep-08 2
Sofield type procedure)
27455 Osteotomy, proximal tibia, including fibular excision or osteotomy (includes 30-Sep-08 1
correction of genu varus [bowleg] or genu valgus [knock-knee]); before
epiphyseal closure
27457 Osteotomy, proximal tibia, including fibular excision or osteotomy (includes 30-Sep-08 1
correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal
closure
27465 Osteoplasty, femur; shortening (excluding 64876) 30-Sep-08 2
27466 Osteoplasty, femur; lengthening 30-Sep-08 2
27468 Osteoplasty, femur; combined, lengthening and shortening with femoral 30-Sep-08 2
segment transfer
27470 Repair, nonunion or malunion, femur, distal to head and neck; without graft (eg, 30-Sep-08 2
compression technique)
27472 Repair, nonunion or malunion, femur, distal to head and neck; with iliac or other 30-Sep-08 2
autogenous bone graft (includes obtaining graft)
27475 Arrest, epiphyseal, any method (eg, epiphysiodesis); distal femur 30-Sep-08 2
27477 Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal 30-Sep-08 2
27479 Arrest, epiphyseal, any method (eg, epiphysiodesis); combined distal femur, 30-Sep-08 2
proximal tibia and fibula
27485 Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus or 30-Sep-08 2
valgus)
27486 Revision of total knee arthroplasty, with or without allograft; 1 component 30-Sep-08 2
27487 Revision of total knee arthroplasty, with or without allograft; femoral and entire 30-Sep-08 2
tibial component
27488 Removal of prosthesis, including total knee prosthesis, methylmethacrylate with 30-Sep-08 2
or without insertion of spacer, knee
27495 Prophylactic treatment (nailing, pinning, plating, or wiring) with or without 30-Sep-08 2
methylmethacrylate, femur
27496 Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or 30-Sep-08 2
extensor or adductor);
27497 Decompression fasciotomy, thigh and/or knee, 1 compartment (flexor or 30-Sep-08 2
extensor or adductor); with debridement of nonviable muscle and/or nerve
27498 Decompression fasciotomy, thigh and/or knee, multiple compartments; 30-Sep-08 2

27499 Decompression fasciotomy, thigh and/or knee, multiple compartments; with 30-Sep-08 2
debridement of nonviable muscle and/or nerve
27500 Closed treatment of femoral shaft fracture, without manipulation 30-Sep-08 2
27501 Closed treatment of supracondylar or transcondylar femoral fracture with or 30-Sep-08 2
without intercondylar extension, without manipulation
27502 Closed treatment of femoral shaft fracture, with manipulation, with or without 30-Sep-08 2
skin or skeletal traction
27503 Closed treatment of supracondylar or transcondylar femoral fracture with or 30-Sep-08 2
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 30-Sep-08 2
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 30-Sep-08 2
cerclage
27508 Closed treatment of femoral fracture, distal end, medial or lateral condyle, 30-Sep-08 2
27509 Percutaneous skeletal fixation of femoral fracture, distal end, medial or lateral 30-Sep-08 2
condyle, or supracondylar or transcondylar, with or without intercondylar
extension, or distal femoral epiphyseal separation
27510 Closed treatment of femoral fracture, distal end, medial or lateral condyle, with 30-Sep-08 2
manipulation
27511 Open treatment of femoral supracondylar or transcondylar fracture without 30-Sep-08 2
intercondylar extension, includes internal fixation, when performed
27513 Open treatment of femoral supracondylar or transcondylar fracture with 30-Sep-08 2

intercondylar extension, includes internal fixation, when performed
27514 Open treatment of femoral fracture, distal end, medial or lateral condyle, 30-Sep-08 2
includes internal fixation, when performed
27516 Closed treatment of distal femoral epiphyseal separation; without manipulation 30-Sep-08 2
27517 Closed treatment of distal femoral epiphyseal separation; with manipulation, 30-Sep-08 2
with or without skin or skeletal traction
27519 Open treatment of distal femoral epiphyseal separation, includes internal 30-Sep-08 2
27520 Closed treatment of patellar fracture, without manipulation 30-Sep-08 2
27524 Open treatment of patellar fracture, with internal fixation and/or partial or 30-Sep-08 2
complete patellectomy and soft tissue repair
27530 Closed treatment of tibial fracture, proximal (plateau); without manipulation 30-Sep-08 2
27532 Closed treatment of tibial fracture, proximal (plateau); with or without 30-Sep-08 2
manipulation, with skeletal traction
27535 Open treatment of tibial fracture, proximal (plateau); unicondylar, includes 30-Sep-08 2
27536 Open treatment of tibial fracture, proximal (plateau); bicondylar, with or without 30-Sep-08 2
internal fixation
27538 Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s) of knee, 30-Sep-08 2
with or without manipulation
27540 Open treatment of intercondylar spine(s) and/or tuberosity fracture(s) of the 30-Sep-08 2
knee, includes internal fixation, when performed
27550 Closed treatment of knee dislocation; without anesthesia 30-Sep-08 2
27552 Closed treatment of knee dislocation; requiring anesthesia 30-Sep-08 2
27556 Open treatment of knee dislocation, includes internal fixation, when performed; 30-Sep-08 2
without primary ligamentous repair or augmentation/reconstruction
with primary ligamentous repair
with primary ligamentous repair, with augmentation/reconstruction
27560 Closed treatment of patellar dislocation; without anesthesia 30-Sep-08 2

27562 Closed treatment of patellar dislocation; requiring anesthesia 30-Sep-08 2
27566 Open treatment of patellar dislocation, with or without partial or total 30-Sep-08 2
patellectomy
27570 Manipulation of knee joint under general anesthesia (includes application of 30-Sep-08 2
traction or other fixation devices)
27580 Arthrodesis, knee, any technique 30-Sep-08 2
27590 Amputation, thigh, through femur, any level; 30-Sep-08 2
27591 Amputation, thigh, through femur, any level; immediate fitting technique 30-Sep-08 2
including first cast
27592 Amputation, thigh, through femur, any level; open, circular (guillotine) 30-Sep-08 2
27594 Amputation, thigh, through femur, any level; secondary closure or scar revision 30-Sep-08 2
27596 Amputation, thigh, through femur, any level; re-amputation 30-Sep-08 2

27598 Disarticulation at knee 30-Sep-08 2
27599 Unlisted procedure, femur or knee 30-Sep-08
27600 Decompression fasciotomy, leg; anterior and/or lateral compartments only 30-Sep-08 2
27601 Decompression fasciotomy, leg; posterior compartment(s) only 30-Sep-08 2

27602 Decompression fasciotomy, leg; anterior and/or lateral, and posterior 30-Sep-08 2
compartment(s)
27603 Incision and drainage, leg or ankle; deep abscess or hematoma 30-Sep-08
27604 Incision and drainage, leg or ankle; infected bursa 30-Sep-08 2
27605 Tenotomy, percutaneous, Achilles tendon (separate procedure); local anesthesia 30-Sep-08 2
27606 Tenotomy, percutaneous, Achilles tendon (separate procedure); general 30-Sep-08 2

anesthesia
27607 Incision (eg, osteomyelitis or bone abscess), leg or ankle 30-Sep-08 2
27610 Arthrotomy, ankle, including exploration, drainage, or removal of foreign body 30-Sep-08 2
27612 Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon 30-Sep-08 2
lengthening
27613 Biopsy, soft tissue of leg or ankle area; superficial 30-Sep-08
27614 Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) 30-Sep-08
27615 Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or ankle 30-Sep-08 2
27616 Radical resection of tumor (eg, malignant neoplasm), soft tissue of leg or ankle 15-Oct-12
27618 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm 30-Sep-08
27619 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 30-Sep-08
less than 5 cm
27620 Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without 30-Sep-08 2
removal of loose or foreign body
27625 Arthrotomy, with synovectomy, ankle; 30-Sep-08 2
27626 Arthrotomy, with synovectomy, ankle; including tenosynovectomy 30-Sep-08 2
27630 Excision of lesion of tendon sheath or capsule (eg, cyst or ganglion), leg and/or 30-Sep-08 2
ankle
27632 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater 15-Oct-12
27634 Excision, tumor, soft tissue of leg or ankle area, subfascial (eg, intramuscular); 5 15-Oct-12
cm or greater
27635 Excision or curettage of bone cyst or benign tumor, tibia or fibula; 30-Sep-08 2
27637 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with autograft 30-Sep-08 2
27638 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft 30-Sep-08 2
27640 Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, 30-Sep-08 2

osteomyelitis); tibia
27641 Partial excision (craterization, saucerization, or diaphysectomy), bone (eg, 30-Sep-08 2
osteomyelitis); fibula
27645 Radical resection of tumor; tibia 30-Sep-08 1
27646 Radical resection of tumor; fibula 30-Sep-08 1
27647 Radical resection of tumor; talus or calcaneus 30-Sep-08 2
27648 Injection procedure for ankle arthrography 30-Sep-08 2
27650 Repair, primary, open or percutaneous, ruptured Achilles tendon; 30-Sep-08 2
27652 Repair, primary, open or percutaneous, ruptured Achilles tendon; with graft 30-Sep-08 2
27654 Repair, secondary, Achilles tendon, with or without graft 30-Sep-08 2
27656 Repair, fascial defect of leg 30-Sep-08 2
27658 Repair, flexor tendon, leg; primary, without graft, each tendon 30-Sep-08 2
27659 Repair, flexor tendon, leg; secondary, with or without graft, each tendon 30-Sep-08 2
27664 Repair, extensor tendon, leg; primary, without graft, each tendon 30-Sep-08 2
27665 Repair, extensor tendon, leg; secondary, with or without graft, each tendon 30-Sep-08 2
27675 Repair, dislocating peroneal tendons; without fibular osteotomy 30-Sep-08 2

27676 Repair, dislocating peroneal tendons; with fibular osteotomy 30-Sep-08 2
27680 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon 30-Sep-08 3
27681 Tenolysis, flexor or extensor tendon, leg and/or ankle; multiple tendons (through 30-Sep-08 2
separate incision(s))
27685 Lengthening or shortening of tendon, leg or ankle; single tendon (separate 30-Sep-08 2
procedure)
27686 Lengthening or shortening of tendon, leg or ankle; multiple tendons (through 30-Sep-08 2
same incision), each
27687 Gastrocnemius recession (eg, Strayer procedure) 30-Sep-08 2
27690 Transfer or transplant of single tendon (with muscle redirection or rerouting); 30-Sep-08 2
superficial (eg, anterior tibial extensors into midfoot)
27691 Transfer or transplant of single tendon (with muscle redirection or rerouting); 30-Sep-08 2
deep (eg, anterior tibial or posterior tibial through interosseous space, flexor
digitorum longus, flexor hallucis longus, or peroneal tendon to midfoot or
hindfoot)
27692 Transfer or transplant of single tendon (with muscle redirection or rerouting); 30-Sep-08
each additional tendon (List separately in addition to code for primary
procedure)
27695 Repair, primary, disrupted ligament, ankle; collateral 30-Sep-08 2
27696 Repair, primary, disrupted ligament, ankle; both collateral ligaments 30-Sep-08 2
27698 Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones 30-Sep-08 2
procedure)
27700 Arthroplasty, ankle; 30-Sep-08 2
27702 Arthroplasty, ankle; with implant (total ankle) 30-Sep-08 2
27703 Arthroplasty, ankle; revision, total ankle 30-Sep-08 2
27704 Removal of ankle implant 30-Sep-08 2
27705 Osteotomy; tibia 30-Sep-08 2
27707 Osteotomy; fibula 30-Sep-08 2
27709 Osteotomy; tibia and fibula 30-Sep-08 2
27712 Osteotomy; multiple, with realignment on intramedullary rod (eg, Sofield type 30-Sep-08 2
procedure)
27715 Osteoplasty, tibia and fibula, lengthening or shortening 30-Sep-08 2
27720 Repair of nonunion or malunion, tibia; without graft, (eg, compression technique) 30-Sep-08 2
27722 Repair of nonunion or malunion, tibia; with sliding graft 30-Sep-08 2

27724 Repair of nonunion or malunion, tibia; with iliac or other autograft (includes 30-Sep-08 2
obtaining graft)
27725 Repair of nonunion or malunion, tibia; by synostosis, with fibula, any method 30-Sep-08 2
27726 Repair of fibula nonunion and/or malunion with internal fixation 30-Sep-08 2
27727 Repair of congenital pseudarthrosis, tibia 30-Sep-08 2
27730 Arrest, epiphyseal (epiphysiodesis), open; distal tibia 30-Sep-08 2
27732 Arrest, epiphyseal (epiphysiodesis), open; distal fibula 30-Sep-08 2
27734 Arrest, epiphyseal (epiphysiodesis), open; distal tibia and fibula 30-Sep-08 2
27740 Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal 30-Sep-08 2
tibia and fibula;
27742 Arrest, epiphyseal (epiphysiodesis), any method, combined, proximal and distal 30-Sep-08 2
tibia and fibula; and distal femur
methylmethacrylate, tibia
27750 Closed treatment of tibial shaft fracture (with or without fibular fracture); without 30-Sep-08 2
manipulation
27752 Closed treatment of tibial shaft fracture (with or without fibular fracture); with 30-Sep-08 2
manipulation, with or without skeletal traction
27756 Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular 30-Sep-08 2
fracture) (eg, pins or screws)
27758 Open treatment of tibial shaft fracture (with or without fibular fracture), with 30-Sep-08 2
plate/screws, with or without cerclage
27759 Treatment of tibial shaft fracture (with or without fibular fracture) by 30-Sep-08 2
intramedullary implant, with or without interlocking screws and/or cerclage
27760 Closed treatment of medial malleolus fracture; without manipulation 30-Sep-08 2
27762 Closed treatment of medial malleolus fracture; with manipulation, with or 30-Sep-08 2
without skin or skeletal traction
27766 Open treatment of medial malleolus fracture, includes internal fixation, when 30-Sep-08 2
performed
27767 Closed treatment of posterior malleolus fracture; without manipulation 30-Sep-08 2
27768 Closed treatment of posterior malleolus fracture; with manipulation 30-Sep-08 2

27769 Open treatment of posterior malleolus fracture, includes internal fixation, when 30-Sep-08 2
performed
27780 Closed treatment of proximal fibula or shaft fracture; without manipulation 30-Sep-08 2
27781 Closed treatment of proximal fibula or shaft fracture; with manipulation 30-Sep-08 2
27784 Open treatment of proximal fibula or shaft fracture, includes internal fixation, 30-Sep-08 2
when performed
27786 Closed treatment of distal fibular fracture (lateral malleolus); without 30-Sep-08 2
manipulation
27788 Closed treatment of distal fibular fracture (lateral malleolus); with manipulation 30-Sep-08 2
27792 Open treatment of distal fibular fracture (lateral malleolus), includes internal 30-Sep-08 2
27808 Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or 30-Sep-08 2
lateral and posterior malleoli or medial and posterior malleoli); without
manipulation
27810 Closed treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or 30-Sep-08 2
lateral and posterior malleoli or medial and posterior malleoli); with
manipulation
27814 Open treatment of bimalleolar ankle fracture (eg, lateral and medial malleoli, or 30-Sep-08 2
lateral and posterior malleoli, or medial and posterior malleoli), includes internal
27816 Closed treatment of trimalleolar ankle fracture; without manipulation 30-Sep-08 2
27818 Closed treatment of trimalleolar ankle fracture; with manipulation 30-Sep-08 2
27822 Open treatment of trimalleolar ankle fracture, includes internal fixation, when 30-Sep-08 2
performed, medial and/or lateral malleolus; without fixation of posterior lip
27823 Open treatment of trimalleolar ankle fracture, includes internal fixation, when 30-Sep-08 2
performed, medial and/or lateral malleolus; with fixation of posterior lip
27824 Closed treatment of fracture of weight bearing articular portion of distal tibia 30-Sep-08 2
(eg, pilon or tibial plafond), with or without anesthesia; without manipulation
27825 Closed treatment of fracture of weight bearing articular portion of distal tibia 30-Sep-08 2
(eg, pilon or tibial plafond), with or without anesthesia; with skeletal traction
and/or requiring manipulation
27826 Open treatment of fracture of weight bearing articular surface/portion of distal 30-Sep-08 2
tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of fibula
only
tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of tibia
only
tibia (eg, pilon or tibial plafond), with internal fixation, when performed; of both
tibia and fibula
27829 Open treatment of distal tibiofibular joint (syndesmosis) disruption, includes 30-Sep-08 2
27830 Closed treatment of proximal tibiofibular joint dislocation; without anesthesia 30-Sep-08 2
27831 Closed treatment of proximal tibiofibular joint dislocation; requiring anesthesia 30-Sep-08 2
27832 Open treatment of proximal tibiofibular joint dislocation, includes internal 30-Sep-08 2
fixation, when performed, or with excision of proximal fibula
27840 Closed treatment of ankle dislocation; without anesthesia 30-Sep-08 2
27842 Closed treatment of ankle dislocation; requiring anesthesia, with or without 30-Sep-08 2
percutaneous skeletal fixation
27846 Open treatment of ankle dislocation, with or without percutaneous skeletal 30-Sep-08 2
fixation; without repair or internal fixation
27848 Open treatment of ankle dislocation, with or without percutaneous skeletal 30-Sep-08 2
fixation; with repair or internal or external fixation
27860 Manipulation of ankle under general anesthesia (includes application of traction 30-Sep-08 2
or other fixation apparatus)
27870 Arthrodesis, ankle, open 30-Sep-08 2
27871 Arthrodesis, tibiofibular joint, proximal or distal 30-Sep-08 2
27880 Amputation, leg, through tibia and fibula; 30-Sep-08 2
27881 Amputation, leg, through tibia and fibula; with immediate fitting technique 30-Sep-08 2
including application of first cast
27882 Amputation, leg, through tibia and fibula; open, circular (guillotine) 30-Sep-08 2
27884 Amputation, leg, through tibia and fibula; secondary closure or scar revision 30-Sep-08 2
27886 Amputation, leg, through tibia and fibula; re-amputation 30-Sep-08 2

27888 Amputation, ankle, through malleoli of tibia and fibula (eg, Syme, Pirogoff type 30-Sep-08 2
procedures), with plastic closure and resection of nerves
27889 Ankle disarticulation 30-Sep-08 2

27892 Decompression fasciotomy, leg; anterior and/or lateral compartments only, with 30-Sep-08 2
27893 Decompression fasciotomy, leg; posterior compartment(s) only, with 30-Sep-08 2
27894 Decompression fasciotomy, leg; anterior and/or lateral, and posterior 30-Sep-08 2
compartment(s), with debridement of nonviable muscle and/or nerve
27899 Unlisted procedure, leg or ankle 30-Sep-08
28001 Incision and drainage, bursa, foot 30-Sep-08 2

28002 Incision and drainage below fascia, with or without tendon sheath involvement, 30-Sep-08 3
foot; single bursal space
28003 Incision and drainage below fascia, with or without tendon sheath involvement, 30-Sep-08 2
foot; multiple areas
28005 Incision, bone cortex (eg, osteomyelitis or bone abscess), foot 30-Sep-08 3
28008 Fasciotomy, foot and/or toe 30-Sep-08
28010 Tenotomy, percutaneous, toe; single tendon 30-Sep-08
28011 Tenotomy, percutaneous, toe; multiple tendons 30-Sep-08
28020 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; 30-Sep-08
intertarsal or tarsometatarsal joint
metatarsophalangeal joint
interphalangeal joint
28035 Release, tarsal tunnel (posterior tibial nerve decompression) 30-Sep-08 2
28039 Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater 15-Oct-12
28041 Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); 1.5 cm 15-Oct-12
or greater
28043 Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm 30-Sep-08
28045 Excision, tumor, soft tissue of foot or toe, subfascial (eg, intramuscular); less 30-Sep-08
than 1.5 cm
28046 Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot or toe; 30-Sep-08
less than 3 cm
28047 Radical resection of tumor (eg, malignant neoplasm), soft tissue of foot or toe; 3 15-Oct-12
cm or greater
28050 Arthrotomy with biopsy; intertarsal or tarsometatarsal joint 30-Sep-08
28052 Arthrotomy with biopsy; metatarsophalangeal joint 30-Sep-08 2
28054 Arthrotomy with biopsy; interphalangeal joint 30-Sep-08 2
28055 Neurectomy, intrinsic musculature of foot 30-Sep-08
28060 Fasciectomy, plantar fascia; partial (separate procedure) 30-Sep-08 2
28062 Fasciectomy, plantar fascia; radical (separate procedure) 30-Sep-08 2
28070 Synovectomy; intertarsal or tarsometatarsal joint, each 30-Sep-08
28072 Synovectomy; metatarsophalangeal joint, each 30-Sep-08
28080 Excision, interdigital (Morton) neuroma, single, each 30-Sep-08
28086 Synovectomy, tendon sheath, foot; flexor 30-Sep-08 2
28088 Synovectomy, tendon sheath, foot; extensor 30-Sep-08 2
28090 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) 30-Sep-08 2
(eg, cyst or ganglion); foot
28092 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) 30-Sep-08 2
(eg, cyst or ganglion); toe(s), each
28100 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; 30-Sep-08 2
28102 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with iliac 30-Sep-08 2
or other autograft (includes obtaining graft)
28103 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with 30-Sep-08 2
allograft
28104 Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except 30-Sep-08
talus or calcaneus;
28106 Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except 30-Sep-08 2
talus or calcaneus; with iliac or other autograft (includes obtaining graft)
28107 Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except 30-Sep-08 2
talus or calcaneus; with allograft
28108 Excision or curettage of bone cyst or benign tumor, phalanges of foot 30-Sep-08 2
28110 Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate 30-Sep-08 2
procedure)
28111 Ostectomy, complete excision; first metatarsal head 30-Sep-08 2
28112 Ostectomy, complete excision; other metatarsal head (second, third or fourth) 30-Sep-08
28113 Ostectomy, complete excision; fifth metatarsal head 30-Sep-08 2

28114 Ostectomy, complete excision; all metatarsal heads, with partial proximal 30-Sep-08 2
phalangectomy, excluding first metatarsal (eg, Clayton type procedure)
28116 Ostectomy, excision of tarsal coalition 30-Sep-08 2

28118 Ostectomy, calcaneus; 30-Sep-08 2
28119 Ostectomy, calcaneus; for spur, with or without plantar fascial release 30-Sep-08 2
28120 Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) 30-Sep-08 2
bone (eg, osteomyelitis or bossing); talus or calcaneus
28122 Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) 30-Sep-08

bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or
calcaneus
28124 Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) 30-Sep-08
bone (eg, osteomyelitis or bossing); phalanx of toe
28126 Resection, partial or complete, phalangeal base, each toe 30-Sep-08
28130 Talectomy (astragalectomy) 30-Sep-08 2
28140 Metatarsectomy 30-Sep-08
28150 Phalangectomy, toe, each toe 30-Sep-08
28153 Resection, condyle(s), distal end of phalanx, each toe 30-Sep-08
28160 Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of 30-Sep-08
phalanx, each
28171 Radical resection of tumor; tarsal (except talus or calcaneus) 30-Sep-08 2
28173 Radical resection of tumor; metatarsal 30-Sep-08 2
28175 Radical resection of tumor; phalanx of toe 30-Sep-08 2
28190 Removal of foreign body, foot; subcutaneous 30-Sep-08
28192 Removal of foreign body, foot; deep 30-Sep-08 2
28193 Removal of foreign body, foot; complicated 30-Sep-08 2
28200 Repair, tendon, flexor, foot; primary or secondary, without free graft, each 30-Sep-08
tendon
28202 Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes 30-Sep-08 2
obtaining graft)
28208 Repair, tendon, extensor, foot; primary or secondary, each tendon 30-Sep-08
28210 Repair, tendon, extensor, foot; secondary with free graft, each tendon (includes 30-Sep-08 2
obtaining graft)
28220 Tenolysis, flexor, foot; single tendon 30-Sep-08 2
28222 Tenolysis, flexor, foot; multiple tendons 30-Sep-08 2
28225 Tenolysis, extensor, foot; single tendon 30-Sep-08 2
28226 Tenolysis, extensor, foot; multiple tendons 30-Sep-08 2
28230 Tenotomy, open, tendon flexor; foot, single or multiple tendon(s) (separate 30-Sep-08 2
procedure)
28232 Tenotomy, open, tendon flexor; toe, single tendon (separate procedure) 30-Sep-08
28234 Tenotomy, open, extensor, foot or toe, each tendon 30-Sep-08

28238 Reconstruction (advancement), posterior tibial tendon with excision of accessory 30-Sep-08 2
tarsal navicular bone (eg, Kidner type procedure)
28240 Tenotomy, lengthening, or release, abductor hallucis muscle 30-Sep-08 2
28250 Division of plantar fascia and muscle (eg, Steindler stripping) (separate 30-Sep-08 2
procedure)
28260 Capsulotomy, midfoot; medial release only (separate procedure) 30-Sep-08 2
28261 Capsulotomy, midfoot; with tendon lengthening 30-Sep-08 2
28262 Capsulotomy, midfoot; extensive, including posterior talotibial capsulotomy and 30-Sep-08 2
tendon(s) lengthening (eg, resistant clubfoot deformity)
28264 Capsulotomy, midtarsal (eg, Heyman type procedure) 30-Sep-08 2

28270 Capsulotomy; metatarsophalangeal joint, with or without tenorrhaphy, each joint 30-Sep-08
28272 Capsulotomy; interphalangeal joint, each joint (separate procedure) 30-Sep-08
28280 Syndactylization, toes (eg, webbing or Kelikian type procedure) 30-Sep-08 2
28285 Correction, hammertoe (eg, interphalangeal fusion, partial or total 30-Sep-08
phalangectomy)
28286 Correction, cock-up fifth toe, with plastic skin closure (eg, Ruiz-Mora type 30-Sep-08 2
procedure)
28288 Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each 30-Sep-08
metatarsal head
28289 Hallux rigidus correction with cheilectomy, debridement and capsular release of 30-Sep-08 2
the first metatarsophalangeal joint
28290 Correction, hallux valgus (bunion), with or without sesamoidectomy; simple 30-Sep-08 2
exostectomy (eg, Silver type procedure)
28292 Correction, hallux valgus (bunion), with or without sesamoidectomy; Keller, 30-Sep-08 2
McBride, or Mayo type procedure
28293 Correction, hallux valgus (bunion), with or without sesamoidectomy; resection of 30-Sep-08 2
joint with implant
28294 Correction, hallux valgus (bunion), with or without sesamoidectomy; with tendon 30-Sep-08 2
transplants (eg, Joplin type procedure)
28296 Correction, hallux valgus (bunion), with or without sesamoidectomy; with 30-Sep-08 2
metatarsal osteotomy (eg, Mitchell, Chevron, or concentric type procedures)
28297 Correction, hallux valgus (bunion), with or without sesamoidectomy; Lapidus- 30-Sep-08 2
type procedure
28298 Correction, hallux valgus (bunion), with or without sesamoidectomy; by phalanx 30-Sep-08 2
osteotomy
28299 Correction, hallux valgus (bunion), with or without sesamoidectomy; by double 30-Sep-08 2
osteotomy
28300 Osteotomy; calcaneus (eg, Dwyer or Chambers type procedure), with or without 30-Sep-08 2
internal fixation
28302 Osteotomy; talus 30-Sep-08 2
28304 Osteotomy, tarsal bones, other than calcaneus or talus; 30-Sep-08 2
28305 Osteotomy, tarsal bones, other than calcaneus or talus; with autograft (includes 30-Sep-08 2
obtaining graft) (eg, Fowler type)
28306 Osteotomy, with or without lengthening, shortening or angular correction, 30-Sep-08 2
metatarsal; first metatarsal
metatarsal; first metatarsal with autograft (other than first toe)
28308 Osteotomy, with or without lengthening, shortening or angular correction, 30-Sep-08

metatarsal; other than first metatarsal, each
metatarsal; multiple (eg, Swanson type cavus foot procedure)
28310 Osteotomy, shortening, angular or rotational correction; proximal phalanx, first 30-Sep-08 2
toe (separate procedure)
28312 Osteotomy, shortening, angular or rotational correction; other phalanges, any 30-Sep-08
toe
28313 Reconstruction, angular deformity of toe, soft tissue procedures only (eg, 30-Sep-08
overlapping second toe, fifth toe, curly toes)
28315 Sesamoidectomy, first toe (separate procedure) 30-Sep-08 2
28320 Repair, nonunion or malunion; tarsal bones 30-Sep-08 2
28322 Repair, nonunion or malunion; metatarsal, with or without bone graft (includes 30-Sep-08 2
obtaining graft)
28340 Reconstruction, toe, macrodactyly; soft tissue resection 30-Sep-08 2
28341 Reconstruction, toe, macrodactyly; requiring bone resection 30-Sep-08 2
28344 Reconstruction, toe(s); polydactyly 30-Sep-08 2
28345 Reconstruction, toe(s); syndactyly, with or without skin graft(s), each web 30-Sep-08
28360 Reconstruction, cleft foot 30-Sep-08 2
28400 Closed treatment of calcaneal fracture; without manipulation 30-Sep-08 2
28405 Closed treatment of calcaneal fracture; with manipulation 30-Sep-08 2
28406 Percutaneous skeletal fixation of calcaneal fracture, with manipulation 30-Sep-08 2
28415 Open treatment of calcaneal fracture, includes internal fixation, when performed; 30-Sep-08 2
28420 Open treatment of calcaneal fracture, includes internal fixation, when 30-Sep-08 2
performed; with primary iliac or other autogenous bone graft (includes obtaining
graft)
28430 Closed treatment of talus fracture; without manipulation 30-Sep-08 2
28435 Closed treatment of talus fracture; with manipulation 30-Sep-08 2
28436 Percutaneous skeletal fixation of talus fracture, with manipulation 30-Sep-08 2
28445 Open treatment of talus fracture, includes internal fixation, when performed 30-Sep-08 2
28446 Open osteochondral autograft, talus (includes obtaining graft[s]) 30-Sep-08 2

28450 Treatment of tarsal bone fracture (except talus and calcaneus); without 30-Sep-08
manipulation, each
28455 Treatment of tarsal bone fracture (except talus and calcaneus); with 30-Sep-08
manipulation, each
28456 Percutaneous skeletal fixation of tarsal bone fracture (except talus and 30-Sep-08
calcaneus), with manipulation, each
28465 Open treatment of tarsal bone fracture (except talus and calcaneus), includes 30-Sep-08
internal fixation, when performed, each
28470 Closed treatment of metatarsal fracture; without manipulation, each 30-Sep-08
28475 Closed treatment of metatarsal fracture; with manipulation, each 30-Sep-08
28476 Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each 30-Sep-08
28485 Open treatment of metatarsal fracture, includes internal fixation, when 30-Sep-08
performed, each
28490 Closed treatment of fracture great toe, phalanx or phalanges; without 30-Sep-08 2
manipulation
28495 Closed treatment of fracture great toe, phalanx or phalanges; with manipulation 30-Sep-08 2
28496 Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with 30-Sep-08 2
manipulation
28505 Open treatment of fracture, great toe, phalanx or phalanges, includes internal 30-Sep-08 2
28510 Closed treatment of fracture, phalanx or phalanges, other than great toe; 30-Sep-08
without manipulation, each
28515 Closed treatment of fracture, phalanx or phalanges, other than great toe; with 30-Sep-08
manipulation, each
28525 Open treatment of fracture, phalanx or phalanges, other than great toe, includes 30-Sep-08
internal fixation, when performed, each
28530 Closed treatment of sesamoid fracture 30-Sep-08 2
28531 Open treatment of sesamoid fracture, with or without internal fixation 30-Sep-08 2
28540 Closed treatment of tarsal bone dislocation, other than talotarsal; without 30-Sep-08 2
anesthesia
28545 Closed treatment of tarsal bone dislocation, other than talotarsal; requiring 30-Sep-08 2
anesthesia
28546 Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, 30-Sep-08 2
with manipulation
28555 Open treatment of tarsal bone dislocation, includes internal fixation, when 30-Sep-08 2
performed
28570 Closed treatment of talotarsal joint dislocation; without anesthesia 30-Sep-08 2
28575 Closed treatment of talotarsal joint dislocation; requiring anesthesia 30-Sep-08 2
28576 Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation 30-Sep-08 2
28585 Open treatment of talotarsal joint dislocation, includes internal fixation, when 30-Sep-08 2
performed
28600 Closed treatment of tarsometatarsal joint dislocation; without anesthesia 30-Sep-08 3
28605 Closed treatment of tarsometatarsal joint dislocation; requiring anesthesia 30-Sep-08 3
28606 Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with 30-Sep-08

manipulation
28615 Open treatment of tarsometatarsal joint dislocation, includes internal fixation, 30-Sep-08
when performed
28630 Closed treatment of metatarsophalangeal joint dislocation; without anesthesia 30-Sep-08 3
28635 Closed treatment of metatarsophalangeal joint dislocation; requiring anesthesia 30-Sep-08
28636 Percutaneous skeletal fixation of metatarsophalangeal joint dislocation, with 30-Sep-08

manipulation
28645 Open treatment of metatarsophalangeal joint dislocation, includes internal 30-Sep-08
28660 Closed treatment of interphalangeal joint dislocation; without anesthesia 30-Sep-08
28665 Closed treatment of interphalangeal joint dislocation; requiring anesthesia 30-Sep-08
28666 Percutaneous skeletal fixation of interphalangeal joint dislocation, with 30-Sep-08

manipulation
28675 Open treatment of interphalangeal joint dislocation, includes internal fixation, 30-Sep-08
when performed
28705 Arthrodesis; pantalar 30-Sep-08 2
28715 Arthrodesis; triple 30-Sep-08 2
28725 Arthrodesis; subtalar 30-Sep-08 2
28730 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; 30-Sep-08 2
28735 Arthrodesis, midtarsal or tarsometatarsal, multiple or transverse; with osteotomy 30-Sep-08 2
(eg, flatfoot correction)
28737 Arthrodesis, with tendon lengthening and advancement, midtarsal, tarsal 30-Sep-08 2
navicular-cuneiform (eg, Miller type procedure)
28740 Arthrodesis, midtarsal or tarsometatarsal, single joint 30-Sep-08
28750 Arthrodesis, great toe; metatarsophalangeal joint 30-Sep-08 2
28755 Arthrodesis, great toe; interphalangeal joint 30-Sep-08 2
28760 Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great 30-Sep-08 2
toe, interphalangeal joint (eg, Jones type procedure)
28800 Amputation, foot; midtarsal (eg, Chopart type procedure) 30-Sep-08 2
28805 Amputation, foot; transmetatarsal 30-Sep-08 2
28810 Amputation, metatarsal, with toe, single 30-Sep-08
28820 Amputation, toe; metatarsophalangeal joint 30-Sep-08
28825 Amputation, toe; interphalangeal joint 30-Sep-08
28890 Extracorporeal shock wave, high energy, performed by a physician, requiring 30-Sep-08 2
anesthesia other than local, including ultrasound guidance, involving the plantar
fascia
28899 Unlisted procedure, foot or toes 30-Sep-08
29000 Application of halo type body cast (see 20661-20663 for insertion) 30-Sep-08 1
29010 Application of Risser jacket, localizer, body; only 30-Sep-08 1
29015 Application of Risser jacket, localizer, body; including head 30-Sep-08 1
29020 Application of turnbuckle jacket, body; only 30-Sep-08 1
29025 Application of turnbuckle jacket, body; including head 30-Sep-08 1
29035 Application of body cast, shoulder to hips; 30-Sep-08 1
29040 Application of body cast, shoulder to hips; including head, Minerva type 30-Sep-08 1
29044 Application of body cast, shoulder to hips; including 1 thigh 30-Sep-08 1

29046 Application of body cast, shoulder to hips; including both thighs 30-Sep-08 1
29049 Application, cast; figure-of-eight 30-Sep-08 1
29055 Application, cast; shoulder spica 30-Sep-08 1
29058 Application, cast; plaster Velpeau 30-Sep-08 1
29065 Application, cast; shoulder to hand (long arm) 30-Sep-08 2
29075 Application, cast; elbow to finger (short arm) 30-Sep-08 2
29085 Application, cast; hand and lower forearm (gauntlet) 30-Sep-08 2
29086 Application, cast; finger (eg, contracture) 30-Sep-08 2
29105 Application of long arm splint (shoulder to hand) 30-Sep-08 2
29125 Application of short arm splint (forearm to hand); static 30-Sep-08 2
29126 Application of short arm splint (forearm to hand); dynamic 30-Sep-08 2
29130 Application of finger splint; static 30-Sep-08
29131 Application of finger splint; dynamic 30-Sep-08
29200 Strapping; thorax 30-Sep-08 1
29220 Strapping; low back 30-Sep-08 14-Oct-12
29240 Strapping; shoulder (eg, Velpeau) 30-Sep-08 2
29260 Strapping; elbow or wrist 30-Sep-08 2
29280 Strapping; hand or finger 30-Sep-08 2
29305 Application of hip spica cast; 1 leg 30-Sep-08 1
29325 Application of hip spica cast; 1 and one-half spica or both legs 30-Sep-08 1
29345 Application of long leg cast (thigh to toes); 30-Sep-08 2
29355 Application of long leg cast (thigh to toes); walker or ambulatory type 30-Sep-08 2
29358 Application of long leg cast brace 30-Sep-08 2
29365 Application of cylinder cast (thigh to ankle) 30-Sep-08 2
29405 Application of short leg cast (below knee to toes); 30-Sep-08 2
29425 Application of short leg cast (below knee to toes); walking or ambulatory type 30-Sep-08 2
29435 Application of patellar tendon bearing (PTB) cast 30-Sep-08 2

29440 Adding walker to previously applied cast 30-Sep-08 2
29445 Application of rigid total contact leg cast 30-Sep-08 2
29450 Application of clubfoot cast with molding or manipulation, long or short leg 30-Sep-08 1
29505 Application of long leg splint (thigh to ankle or toes) 30-Sep-08 2

29515 Application of short leg splint (calf to foot) 30-Sep-08 2
29520 Strapping; hip 30-Sep-08 2
29530 Strapping; knee 30-Sep-08 2
29540 Strapping; ankle and/or foot 30-Sep-08 2
29550 Strapping; toes 30-Sep-08 2
29580 Strapping; Unna boot 30-Sep-08 2
29581 Application of multi-layer venous wound compression system, below knee 15-Oct-12
29590 Denis-Browne splint strapping 30-Sep-08 2

29700 Removal or bivalving; gauntlet, boot or body cast 30-Sep-08 2
29705 Removal or bivalving; full arm or full leg cast 30-Sep-08 2
29710 Removal or bivalving; shoulder or hip spica, Minerva, or Risser jacket, etc. 30-Sep-08 2
29715 Removal or bivalving; turnbuckle jacket 30-Sep-08 1

29720 Repair of spica, body cast or jacket 30-Sep-08 1
29730 Windowing of cast 30-Sep-08 2
29740 Wedging of cast (except clubfoot casts) 30-Sep-08 1
29750 Wedging of clubfoot cast 30-Sep-08 1
29799 Unlisted procedure, casting or strapping 30-Sep-08
29800 Arthroscopy, temporomandibular joint, diagnostic, with or without synovial 30-Sep-08 2

biopsy (separate procedure)
29804 Arthroscopy, temporomandibular joint, surgical 30-Sep-08 2
29805 Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate 30-Sep-08 2
procedure)
29806 Arthroscopy, shoulder, surgical; capsulorrhaphy 30-Sep-08 2
29807 Arthroscopy, shoulder, surgical; repair of SLAP lesion 30-Sep-08 2
29819 Arthroscopy, shoulder, surgical; with removal of loose body or foreign body 30-Sep-08 2
29820 Arthroscopy, shoulder, surgical; synovectomy, partial 30-Sep-08 2

29821 Arthroscopy, shoulder, surgical; synovectomy, complete 30-Sep-08 2
29822 Arthroscopy, shoulder, surgical; debridement, limited 30-Sep-08 2
29823 Arthroscopy, shoulder, surgical; debridement, extensive 30-Sep-08 2
29824 Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular 30-Sep-08 2
surface (Mumford procedure)
29825 Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or 30-Sep-08 2
29826 Arthroscopy, shoulder, surgical; decompression of subacromial space with partial 30-Sep-08 2
acromioplasty, with or without coracoacromial release
29827 Arthroscopy, shoulder, surgical; with rotator cuff repair 30-Sep-08 2
29828 Arthroscopy, shoulder, surgical; biceps tenodesis 30-Sep-08 2
29830 Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate 30-Sep-08 2
procedure)
29834 Arthroscopy, elbow, surgical; with removal of loose body or foreign body 30-Sep-08 2
29835 Arthroscopy, elbow, surgical; synovectomy, partial 30-Sep-08 2

29836 Arthroscopy, elbow, surgical; synovectomy, complete 30-Sep-08 2
29837 Arthroscopy, elbow, surgical; debridement, limited 30-Sep-08 2
29838 Arthroscopy, elbow, surgical; debridement, extensive 30-Sep-08 2
29840 Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate 30-Sep-08 2
procedure)
29843 Arthroscopy, wrist, surgical; for infection, lavage and drainage 30-Sep-08 2
29844 Arthroscopy, wrist, surgical; synovectomy, partial 30-Sep-08 2
29845 Arthroscopy, wrist, surgical; synovectomy, complete 30-Sep-08 2
29846 Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage 30-Sep-08 2
and/or joint debridement
29847 Arthroscopy, wrist, surgical; internal fixation for fracture or instability 30-Sep-08 2
29848 Endoscopy, wrist, surgical, with release of transverse carpal ligament 30-Sep-08 2
29850 Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity 30-Sep-08 2
fracture(s) of the knee, with or without manipulation; without internal or external
fixation (includes arthroscopy)
29851 Arthroscopically aided treatment of intercondylar spine(s) and/or tuberosity 30-Sep-08 2
fracture(s) of the knee, with or without manipulation; with internal or external
fixation (includes arthroscopy)
29855 Arthroscopically aided treatment of tibial fracture, proximal (plateau); 30-Sep-08 2
unicondylar, includes internal fixation, when performed (includes arthroscopy)
29856 Arthroscopically aided treatment of tibial fracture, proximal (plateau); 30-Sep-08 2

bicondylar, includes internal fixation, when performed (includes arthroscopy)
29860 Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure) 30-Sep-08 2
29861 Arthroscopy, hip, surgical; with removal of loose body or foreign body 30-Sep-08 2
29862 Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage 30-Sep-08 2
(chondroplasty), abrasion arthroplasty, and/or resection of labrum
29863 Arthroscopy, hip, surgical; with synovectomy 30-Sep-08 2

29866 Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) 30-Sep-08 2
(includes harvesting of the autograft[s])
29867 Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty) 30-Sep-08 2
29868 Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for 30-Sep-08 2
meniscal insertion), medial or lateral
29870 Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate 30-Sep-08 2
procedure)
29871 Arthroscopy, knee, surgical; for infection, lavage and drainage 30-Sep-08 2
29873 Arthroscopy, knee, surgical; with lateral release 30-Sep-08 2
29874 Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, 30-Sep-08 2
osteochondritis dissecans fragmentation, chondral fragmentation)
29875 Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) 30-Sep-08 2
29876 Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, 30-Sep-08 2
medial or lateral)
29877 Arthroscopy, knee, surgical; debridement/shaving of articular cartilage 30-Sep-08 2
(chondroplasty)
29879 Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where 30-Sep-08 2
necessary) or multiple drilling or microfracture
29880 Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including 30-Sep-08 2
any meniscal shaving)
29881 Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including 30-Sep-08 2
any meniscal shaving)
29882 Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral) 30-Sep-08 2
29883 Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral) 30-Sep-08 2
29884 Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation 30-Sep-08 2
29885 Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone 30-Sep-08 2
grafting, with or without internal fixation (including debridement of base of
lesion)
29886 Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion 30-Sep-08 2
29887 Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion 30-Sep-08 2
with internal fixation
29888 Arthroscopically aided anterior cruciate ligament repair/augmentation or 30-Sep-08 2
reconstruction
29889 Arthroscopically aided posterior cruciate ligament repair/augmentation or 30-Sep-08 2
reconstruction
29891 Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or 30-Sep-08 2
tibia, including drilling of the defect
29892 Arthroscopically aided repair of large osteochondritis dissecans lesion, talar 30-Sep-08 2
dome fracture, or tibial plafond fracture, with or without internal fixation
(includes arthroscopy)
29893 Endoscopic plantar fasciotomy 30-Sep-08 2
29894 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of 30-Sep-08 2
loose body or foreign body
29895 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, 30-Sep-08 2
partial
29897 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, 30-Sep-08 2
limited
29898 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, 30-Sep-08 2
extensive
29899 Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle 30-Sep-08 2
arthrodesis
29900 Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy 30-Sep-08 2
29901 Arthroscopy, metacarpophalangeal joint, surgical; with debridement 30-Sep-08 2

29902 Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced 30-Sep-08 2
ulnar collateral ligament (eg, Stenar lesion)
29904 Arthroscopy, subtalar joint, surgical; with removal of loose body or foreign body 30-Sep-08 2
29905 Arthroscopy, subtalar joint, surgical; with synovectomy 30-Sep-08 2

29906 Arthroscopy, subtalar joint, surgical; with debridement 30-Sep-08 2
29907 Arthroscopy, subtalar joint, surgical; with subtalar arthrodesis 30-Sep-08 2
29914 Arthroscopy, hip, surgical; with femoroplasty (ie, treatment of cam lesion) 15-Oct-12 2
29915 Arthroscopy, subtalar joint, surgical; with acetabuloplasty (ie, treatment of 15-Oct-12 2
pincer lesion)
29916 Arthroscopy, subtalar joint, surgical; with labral repair 15-Oct-12 2
29999 Unlisted procedure, arthroscopy 30-Sep-08
30000 Drainage abscess or hematoma, nasal, internal approach 30-Sep-08 1

30020 Drainage abscess or hematoma, nasal septum 30-Sep-08 1
30100 Biopsy, intranasal 30-Sep-08 3
30110 Excision, nasal polyp(s), simple 30-Sep-08 1
30115 Excision, nasal polyp(s), extensive 30-Sep-08 1
30117 Excision or destruction (eg, laser), intranasal lesion; internal approach 30-Sep-08 2
30118 Excision or destruction (eg, laser), intranasal lesion; external approach (lateral 30-Sep-08 2
rhinotomy)
30120 Excision or surgical planing of skin of nose for rhinophyma 30-Sep-08 1
30124 Excision dermoid cyst, nose; simple, skin, subcutaneous 30-Sep-08 2
30125 Excision dermoid cyst, nose; complex, under bone or cartilage 30-Sep-08 1
30130 Excision inferior turbinate, partial or complete, any method 30-Sep-08 2
30140 Submucous resection inferior turbinate, partial or complete, any method 30-Sep-08 2
30150 Rhinectomy; partial 30-Sep-08 1

30160 Rhinectomy; total 30-Sep-08 1
30200 Injection into turbinate(s), therapeutic 30-Sep-08 1
30210 Displacement therapy (Proetz type) 30-Sep-08 1
30220 Insertion, nasal septal prosthesis (button) 30-Sep-08 1
30300 Removal foreign body, intranasal; office type procedure 30-Sep-08 1
30310 Removal foreign body, intranasal; requiring general anesthesia 30-Sep-08 1
30320 Removal foreign body, intranasal; by lateral rhinotomy 30-Sep-08 1
30400 Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip 30-Sep-08 1
30410 Rhinoplasty, primary; complete, external parts including bony pyramid, lateral 30-Sep-08 1
and alar cartilages, and/or elevation of nasal tip
30420 Rhinoplasty, primary; including major septal repair 30-Sep-08 1
30430 Rhinoplasty, secondary; minor revision (small amount of nasal tip work) 30-Sep-08 1
30435 Rhinoplasty, secondary; intermediate revision (bony work with osteotomies) 30-Sep-08 1
30450 Rhinoplasty, secondary; major revision (nasal tip work and osteotomies) 30-Sep-08 1
30460 Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, 30-Sep-08 1
including columellar lengthening; tip only
30462 Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, 30-Sep-08 1
including columellar lengthening; tip, septum, osteotomies
30465 Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall 30-Sep-08 1
reconstruction)
30520 Septoplasty or submucous resection, with or without cartilage scoring, 30-Sep-08 1
contouring or replacement with graft
30540 Repair choanal atresia; intranasal 30-Sep-08 1
30545 Repair choanal atresia; transpalatine 30-Sep-08 1
30560 Lysis intranasal synechia 30-Sep-08 1
30580 Repair fistula; oromaxillary (combine with 31030 if antrotomy is included) 30-Sep-08 2
30600 Repair fistula; oronasal 30-Sep-08 1

30620 Septal or other intranasal dermatoplasty (does not include obtaining graft) 30-Sep-08 1
30630 Repair nasal septal perforations 30-Sep-08 1

30801 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, 30-Sep-08 1
electrocautery, radiofrequency ablation, or tissue volume reduction); superficial
30802 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (eg, 30-Sep-08 1
electrocautery, radiofrequency ablation, or tissue volume reduction); intramural
(ie, submucosal)
30901 Control nasal hemorrhage, anterior, simple (limited cautery and/or packing) any 30-Sep-08 1
method
30903 Control nasal hemorrhage, anterior, complex (extensive cautery and/or packing) 30-Sep-08 1
any method
30905 Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, 30-Sep-08 1
any method; initial
30906 Control nasal hemorrhage, posterior, with posterior nasal packs and/or cautery, 30-Sep-08 1
any method; subsequent
30915 Ligation arteries; ethmoidal 30-Sep-08 1
30920 Ligation arteries; internal maxillary artery, transantral 30-Sep-08 1
30930 Fracture nasal inferior turbinate(s), therapeutic 30-Sep-08 1
30999 Unlisted procedure, nose 30-Sep-08
31000 Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium) 30-Sep-08 1
31002 Lavage by cannulation; sphenoid sinus 30-Sep-08 2

31020 Sinusotomy, maxillary (antrotomy); intranasal 30-Sep-08 1
31030 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of 30-Sep-08 1
antrochoanal polyps
31032 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of 30-Sep-08 1
antrochoanal polyps
31040 Pterygomaxillary fossa surgery, any approach 30-Sep-08 2
31050 Sinusotomy, sphenoid, with or without biopsy; 30-Sep-08 2
31051 Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal 30-Sep-08 2
of polyp(s)
31070 Sinusotomy frontal; external, simple (trephine operation) 30-Sep-08 2
31075 Sinusotomy frontal; transorbital, unilateral (for mucocele or osteoma, Lynch 30-Sep-08 2
type)
31080 Sinusotomy frontal; obliterative without osteoplastic flap, brow incision (includes 30-Sep-08 2
ablation)
31081 Sinusotomy frontal; obliterative, without osteoplastic flap, coronal incision 30-Sep-08 2
(includes ablation)
31084 Sinusotomy frontal; obliterative, with osteoplastic flap, brow incision 30-Sep-08 2
31085 Sinusotomy frontal; obliterative, with osteoplastic flap, coronal incision 30-Sep-08 2
31086 Sinusotomy frontal; nonobliterative, with osteoplastic flap, brow incision 30-Sep-08 2
31087 Sinusotomy frontal; nonobliterative, with osteoplastic flap, coronal incision 30-Sep-08 2
31090 Sinusotomy, unilateral, 3 or more paranasal sinuses (frontal, maxillary, ethmoid, 30-Sep-08 2
sphenoid)
31200 Ethmoidectomy; intranasal, anterior 30-Sep-08 2
31201 Ethmoidectomy; intranasal, total 30-Sep-08 2
31205 Ethmoidectomy; extranasal, total 30-Sep-08 2
31225 Maxillectomy; without orbital exenteration 30-Sep-08 2
31230 Maxillectomy; with orbital exenteration (en bloc) 30-Sep-08 1
31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) 30-Sep-08 1
31233 Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior 30-Sep-08 2
meatus or canine fossa puncture)
31235 Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via puncture of 30-Sep-08 2
sphenoidal face or cannulation of ostium)
31237 Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or debridement 30-Sep-08 2
31238 Nasal/sinus endoscopy, surgical; with control of nasal hemorrhage 30-Sep-08 2
31239 Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy 30-Sep-08 2
31240 Nasal/sinus endoscopy, surgical; with concha bullosa resection 30-Sep-08 2
31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior) 30-Sep-08 2
31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and 30-Sep-08 2
posterior)
31256 Nasal/sinus endoscopy, surgical, with maxillary antrostomy; 30-Sep-08 2
31267 Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of 30-Sep-08 2
tissue from maxillary sinus
31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without 30-Sep-08 2
removal of tissue from frontal sinus
31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy; 30-Sep-08 2
31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue 30-Sep-08 2
from the sphenoid sinus
31290 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid 30-Sep-08 2
region
31291 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid 30-Sep-08 2
region
31292 Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall 30-Sep-08 2
decompression
31293 Nasal/sinus endoscopy, surgical; with medial orbital wall and inferior orbital wall 30-Sep-08 2
decompression
31294 Nasal/sinus endoscopy, surgical; with optic nerve decompression 30-Sep-08 2
31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, 15-Oct-12 2
balloon dilation), transnasal or via canine fossa
31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon 15-Oct-12 2
dilation)
31297 Nasal/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, 15-Oct-12 2
balloon dilation)
31299 Unlisted procedure, accessory sinuses 30-Sep-08
31300 Laryngotomy (thyrotomy, laryngofissure); with removal of tumor or laryngocele, 30-Sep-08 1

cordectomy
31320 Laryngotomy (thyrotomy, laryngofissure); diagnostic 30-Sep-08 1
31360 Laryngectomy; total, without radical neck dissection 30-Sep-08 1
31365 Laryngectomy; total, with radical neck dissection 30-Sep-08 1
31367 Laryngectomy; subtotal supraglottic, without radical neck dissection 30-Sep-08 1
31368 Laryngectomy; subtotal supraglottic, with radical neck dissection 30-Sep-08 1
31370 Partial laryngectomy (hemilaryngectomy); horizontal 30-Sep-08 1
31375 Partial laryngectomy (hemilaryngectomy); laterovertical 30-Sep-08 1
31380 Partial laryngectomy (hemilaryngectomy); anterovertical 30-Sep-08 1
31382 Partial laryngectomy (hemilaryngectomy); antero-latero-vertical 30-Sep-08 1
31390 Pharyngolaryngectomy, with radical neck dissection; without reconstruction 30-Sep-08 1
31395 Pharyngolaryngectomy, with radical neck dissection; with reconstruction 30-Sep-08 1
31400 Arytenoidectomy or arytenoidopexy, external approach 30-Sep-08 1

31420 Epiglottidectomy 30-Sep-08 1
31500 Intubation, endotracheal, emergency procedure 30-Sep-08 2
31502 Tracheotomy tube change prior to establishment of fistula tract 30-Sep-08 1
31505 Laryngoscopy, indirect; diagnostic (separate procedure) 30-Sep-08 1
31510 Laryngoscopy, indirect; with biopsy 30-Sep-08 1
31511 Laryngoscopy, indirect; with removal of foreign body 30-Sep-08 1
31512 Laryngoscopy, indirect; with removal of lesion 30-Sep-08 1
31513 Laryngoscopy, indirect; with vocal cord injection 30-Sep-08 1
31515 Laryngoscopy direct, with or without tracheoscopy; for aspiration 30-Sep-08 1
31520 Laryngoscopy direct, with or without tracheoscopy; diagnostic, newborn 30-Sep-08 1
31525 Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn 30-Sep-08 1
31526 Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating 30-Sep-08 1
microscope or telescope
31527 Laryngoscopy direct, with or without tracheoscopy; with insertion of obturator 30-Sep-08 1
31528 Laryngoscopy direct, with or without tracheoscopy; with dilation, initial 30-Sep-08 1
31529 Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent 30-Sep-08 1
31530 Laryngoscopy, direct, operative, with foreign body removal; 30-Sep-08 1

31531 Laryngoscopy, direct, operative, with foreign body removal; with operating 30-Sep-08 1
31535 Laryngoscopy, direct, operative, with biopsy; 30-Sep-08 1
31536 Laryngoscopy, direct, operative, with biopsy; with operating microscope or 30-Sep-08 1
telescope
31540 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal 30-Sep-08 1
cords or epiglottis;
31541 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal 30-Sep-08 1
cords or epiglottis; with operating microscope or telescope
31545 Laryngoscopy, direct, operative, with operating microscope or telescope, with 30-Sep-08 2
submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction
with local tissue flap(s)
31546 Laryngoscopy, direct, operative, with operating microscope or telescope, with 30-Sep-08 2
submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction
with graft(s) (includes obtaining autograft)
31560 Laryngoscopy, direct, operative, with arytenoidectomy; 30-Sep-08 1
31561 Laryngoscopy, direct, operative, with arytenoidectomy; with operating 30-Sep-08 1
31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; 30-Sep-08 1
31571 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with 30-Sep-08 1
operating microscope or telescope
31575 Laryngoscopy, flexible fiberoptic; diagnostic 30-Sep-08 1
31576 Laryngoscopy, flexible fiberoptic; with biopsy 30-Sep-08 1
31577 Laryngoscopy, flexible fiberoptic; with removal of foreign body 30-Sep-08 1
31578 Laryngoscopy, flexible fiberoptic; with removal of lesion 30-Sep-08 1
31579 Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy 30-Sep-08 1
31580 Laryngoplasty; for laryngeal web, 2-stage, with keel insertion and removal 30-Sep-08 1
31582 Laryngoplasty; for laryngeal stenosis, with graft or core mold, including 30-Sep-08 1
tracheotomy
31584 Laryngoplasty; with open reduction of fracture 30-Sep-08 1
31587 Laryngoplasty, cricoid split 30-Sep-08 1
31588 Laryngoplasty, not otherwise specified (eg, for burns, reconstruction after partial 30-Sep-08 1
laryngectomy)
31590 Laryngeal reinnervation by neuromuscular pedicle 30-Sep-08 1
31595 Section recurrent laryngeal nerve, therapeutic (separate procedure), unilateral 30-Sep-08 2
31599 Unlisted procedure, larynx 30-Sep-08
31600 Tracheostomy, planned (separate procedure); 30-Sep-08 1

31601 Tracheostomy, planned (separate procedure); younger than 2 years 30-Sep-08 1
31603 Tracheostomy, emergency procedure; transtracheal 30-Sep-08 1
31605 Tracheostomy, emergency procedure; cricothyroid membrane 30-Sep-08 1
31610 Tracheostomy, fenestration procedure with skin flaps 30-Sep-08 1
31611 Construction of tracheoesophageal fistula and subsequent insertion of an 30-Sep-08 1
alaryngeal speech prosthesis (eg, voice button, Blom-Singer prosthesis)
31612 Tracheal puncture, percutaneous with transtracheal aspiration and/or injection 30-Sep-08 1
31613 Tracheostoma revision; simple, without flap rotation 30-Sep-08 1

31614 Tracheostoma revision; complex, with flap rotation 30-Sep-08 1
31615 Tracheobronchoscopy through established tracheostomy incision 30-Sep-08 1
31620 Endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic 30-Sep-08 1
intervention(s) (List separately in addition to code for primary procedure[s])
31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 30-Sep-08 1
performed; diagnostic, with cell washing, when performed (separate procedure)

performed; with brushing or protected brushings
performed; with bronchial alveolar lavage
performed; with bronchial or endobronchial biopsy(s), single or multiple sites
31626 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 15-Oct-12

performed; with placement of fiducial markers, single or multiple
31627 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 15-Oct-12

performed; with computer-assisted, image-guided navigation (List separately in
addition to code for primary procedure[s])
performed; with transbronchial lung biopsy(s), single lobe
performed; with transbronchial needle aspiration biopsy(s), trachea, main stem
and/or lobar bronchus(i)
performed; with tracheal/bronchial dilation or closed reduction of fracture

performed; with placement of tracheal stent(s) (includes tracheal/bronchial
dilation as required)
performed; with transbronchial lung biopsy(s), each additional lobe (List
performed; with transbronchial needle aspiration biopsy(s), each additional lobe
31634 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 15-Oct-12 1

performed; with balloon occlusion, with assessment of air leak, with
administration of occlusive substance (eg, fibrin glue), if performed

performed; with removal of foreign body
performed; with placement of bronchial stent(s) (includes tracheal/bronchial
dilation as required), initial bronchus
performed; each additional major bronchus stented (List separately in addition
performed; with revision of tracheal or bronchial stent inserted at previous
session (includes tracheal/bronchial dilation as required)
performed; with excision of tumor
performed; with destruction of tumor or relief of stenosis by any method other
than excision (eg, laser therapy, cryotherapy)
performed; with placement of catheter(s) for intracavitary radioelement
application
performed; with therapeutic aspiration of tracheobronchial tree, initial (eg,
drainage of lung abscess)
performed; with therapeutic aspiration of tracheobronchial tree, subsequent

performed; with injection of contrast material for segmental bronchography
(fiberscope only)
31715 Transtracheal injection for bronchography 30-Sep-08 1
31717 Catheterization with bronchial brush biopsy 30-Sep-08 1
31720 Catheter aspiration (separate procedure); nasotracheal 30-Sep-08 1
31725 Catheter aspiration (separate procedure); tracheobronchial with fiberscope, 30-Sep-08 1
bedside
31730 Transtracheal (percutaneous) introduction of needle wire dilator/stent or 30-Sep-08 1
indwelling tube for oxygen therapy
31750 Tracheoplasty; cervical 30-Sep-08 1
31755 Tracheoplasty; tracheopharyngeal fistulization, each stage 30-Sep-08 1
31760 Tracheoplasty; intrathoracic 30-Sep-08 1
31766 Carinal reconstruction 30-Sep-08 1
31770 Bronchoplasty; graft repair 30-Sep-08 2
31775 Bronchoplasty; excision stenosis and anastomosis 30-Sep-08 1
31780 Excision tracheal stenosis and anastomosis; cervical 30-Sep-08 1
31781 Excision tracheal stenosis and anastomosis; cervicothoracic 30-Sep-08 1
31785 Excision of tracheal tumor or carcinoma; cervical 30-Sep-08 1
31786 Excision of tracheal tumor or carcinoma; thoracic 30-Sep-08 1
31800 Suture of tracheal wound or injury; cervical 30-Sep-08 1
31805 Suture of tracheal wound or injury; intrathoracic 30-Sep-08 1
31820 Surgical closure tracheostomy or fistula; without plastic repair 30-Sep-08 1
31825 Surgical closure tracheostomy or fistula; with plastic repair 30-Sep-08 1
31830 Revision of tracheostomy scar 30-Sep-08 1
31899 Unlisted procedure, trachea, bronchi 30-Sep-08
32035 Thoracostomy; with rib resection for empyema 30-Sep-08 2

32036 Thoracostomy; with open flap drainage for empyema 30-Sep-08 2
32095 Thoracotomy, limited, for biopsy of lung or pleura 30-Sep-08 2
32100 Thoracotomy, major; with exploration and biopsy 30-Sep-08 1
32110 Thoracotomy, major; with control of traumatic hemorrhage and/or repair of lung 30-Sep-08 2
tear
32120 Thoracotomy, major; for postoperative complications 30-Sep-08 1
32124 Thoracotomy, major; with open intrapleural pneumonolysis 30-Sep-08 2
32140 Thoracotomy, major; with cyst(s) removal, with or without a pleural procedure 30-Sep-08 1
32141 Thoracotomy, major; with excision-plication of bullae, with or without any pleural 30-Sep-08 1
procedure
32150 Thoracotomy, major; with removal of intrapleural foreign body or fibrin deposit 30-Sep-08 1
32151 Thoracotomy, major; with removal of intrapulmonary foreign body 30-Sep-08 1

32160 Thoracotomy, major; with cardiac massage 30-Sep-08 1
32200 Pneumonostomy; with open drainage of abscess or cyst 30-Sep-08 2
32201 Pneumonostomy; with percutaneous drainage of abscess or cyst 30-Sep-08 2
32215 Pleural scarification for repeat pneumothorax 30-Sep-08 2
32220 Decortication, pulmonary (separate procedure); total 30-Sep-08 2
32225 Decortication, pulmonary (separate procedure); partial 30-Sep-08 2
32310 Pleurectomy, parietal (separate procedure) 30-Sep-08
32320 Decortication and parietal pleurectomy 30-Sep-08
32400 Biopsy, pleura; percutaneous needle 30-Sep-08 2
32402 Biopsy, pleura; open 30-Sep-08 2
32405 Biopsy, lung or mediastinum, percutaneous needle 30-Sep-08 2
32420 Pneumocentesis, puncture of lung for aspiration 30-Sep-08 2
32421 Thoracentesis, puncture of pleural cavity for aspiration, initial or subsequent 30-Sep-08 3
32422 Thoracentesis with insertion of tube, includes water seal (eg, for pneumothorax), 30-Sep-08 3
when performed (separate procedure)
32440 Removal of lung, total pneumonectomy; 30-Sep-08 1
32442 Removal of lung, total pneumonectomy; with resection of segment of trachea 30-Sep-08 1
followed by broncho-tracheal anastomosis (sleeve pneumonectomy)
32445 Removal of lung, total pneumonectomy; extrapleural 30-Sep-08 1

32480 Removal of lung, other than total pneumonectomy; single lobe (lobectomy) 30-Sep-08 2
32482 Removal of lung, other than total pneumonectomy; 2 lobes (bilobectomy) 30-Sep-08 1
32484 Removal of lung, other than total pneumonectomy; single segment 30-Sep-08 2
(segmentectomy)
32486 Removal of lung, other than total pneumonectomy; with circumferential 30-Sep-08 1
resection of segment of bronchus followed by broncho-bronchial anastomosis
(sleeve lobectomy)
32488 Removal of lung, other than total pneumonectomy; all remaining lung following 30-Sep-08 1
previous removal of a portion of lung (completion pneumonectomy)
32491 Removal of lung, other than total pneumonectomy; excision-plication of 30-Sep-08

emphysematous lung(s) (bullous or non-bullous) for lung volume reduction,
sternal split or transthoracic approach, with or without any pleural procedure
32500 Removal of lung, other than total pneumonectomy; wedge resection, single or 30-Sep-08 2
multiple
32501 Resection and repair of portion of bronchus (bronchoplasty) when performed at 30-Sep-08 1
time of lobectomy or segmentectomy (List separately in addition to code for
primary procedure)
32503 Resection of apical lung tumor (eg, Pancoast tumor), including chest wall 30-Sep-08
resection, rib(s) resection(s), neurovascular dissection, when performed; without
chest wall reconstruction(s)
32504 Resection of apical lung tumor (eg, Pancoast tumor), including chest wall 30-Sep-08
resection, rib(s) resection(s), neurovascular dissection, when performed; with
chest wall reconstruction
32540 Extrapleural enucleation of empyema (empyemectomy) 30-Sep-08 1
32550 Insertion of indwelling tunneled pleural catheter with cuff 30-Sep-08 2
32551 Tube thoracostomy, includes water seal (eg, for abscess, hemothorax, 30-Sep-08
empyema), when performed (separate procedure)
32552 Removal of indwelling tunneled pleural catheter with cuff 15-Oct-12
32553 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial 15-Oct-12
markers, dosimeter), percutaneous, intra-thoracic, single or multiple
32560 Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent 30-Sep-08
or persistent pneumothorax)
32561 Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic 15-Oct-12
agent for break up of multiloculated effusion); initial day
32562 Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic 15-Oct-12
agent for break up of multiloculated effusion); subsequent day
32601 Thoracoscopy, diagnostic (separate procedure); lungs and pleural space, without 30-Sep-08 1
biopsy
32602 Thoracoscopy, diagnostic (separate procedure); lungs and pleural space, with 30-Sep-08 1
biopsy
32603 Thoracoscopy, diagnostic (separate procedure); pericardial sac, without biopsy 30-Sep-08 1
32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy 30-Sep-08 1
32605 Thoracoscopy, diagnostic (separate procedure); mediastinal space, without 30-Sep-08 1

biopsy
32606 Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy 30-Sep-08 1
32650 Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical) 30-Sep-08 2

32651 Thoracoscopy, surgical; with partial pulmonary decortication 30-Sep-08 2
32652 Thoracoscopy, surgical; with total pulmonary decortication, including intrapleural 30-Sep-08 2
pneumonolysis
32653 Thoracoscopy, surgical; with removal of intrapleural foreign body or fibrin deposit 30-Sep-08 1
32654 Thoracoscopy, surgical; with control of traumatic hemorrhage 30-Sep-08 2

32655 Thoracoscopy, surgical; with excision-plication of bullae, including any pleural 30-Sep-08 2
procedure
32656 Thoracoscopy, surgical; with parietal pleurectomy 30-Sep-08 2
32657 Thoracoscopy, surgical; with wedge resection of lung, single or multiple 30-Sep-08 2
32658 Thoracoscopy, surgical; with removal of clot or foreign body from pericardial sac 30-Sep-08 1
32659 Thoracoscopy, surgical; with creation of pericardial window or partial resection of 30-Sep-08 1
pericardial sac for drainage
32660 Thoracoscopy, surgical; with total pericardiectomy 30-Sep-08 1
32661 Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass 30-Sep-08 1
32662 Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or mass 30-Sep-08 1
32663 Thoracoscopy, surgical; with lobectomy, total or segmental 30-Sep-08 2

32664 Thoracoscopy, surgical; with thoracic sympathectomy 30-Sep-08 2
32665 Thoracoscopy, surgical; with esophagomyotomy (Heller type) 30-Sep-08 1
32800 Repair lung hernia through chest wall 30-Sep-08 1
32810 Closure of chest wall following open flap drainage for empyema (Clagett type 30-Sep-08 1
procedure)
32815 Open closure of major bronchial fistula 30-Sep-08 1
32820 Major reconstruction, chest wall (posttraumatic) 30-Sep-08 1
32850 Donor pneumonectomy(s) (including cold preservation), from cadaver donor 30-Sep-08 1
32851 Lung transplant, single; without cardiopulmonary bypass 30-Sep-08 1
32852 Lung transplant, single; with cardiopulmonary bypass 30-Sep-08 1
32853 Lung transplant, double (bilateral sequential or en bloc); without 30-Sep-08 1

cardiopulmonary bypass
32854 Lung transplant, double (bilateral sequential or en bloc); with cardiopulmonary 30-Sep-08 1
bypass
32855 Backbench standard preparation of cadaver donor lung allograft prior to 30-Sep-08 1
transplantation, including dissection of allograft from surrounding soft tissues to
prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus;
unilateral
32856 Backbench standard preparation of cadaver donor lung allograft prior to 30-Sep-08 1
prepare pulmonary venous/atrial cuff, pulmonary artery, and bronchus; bilateral
32900 Resection of ribs, extrapleural, all stages 30-Sep-08 1

32905 Thoracoplasty, Schede type or extrapleural (all stages); 30-Sep-08 1
32906 Thoracoplasty, Schede type or extrapleural (all stages); with closure of 30-Sep-08 1
bronchopleural fistula
32940 Pneumonolysis, extraperiosteal, including filling or packing procedures 30-Sep-08 1
32960 Pneumothorax, therapeutic, intrapleural injection of air 30-Sep-08 1

32997 Total lung lavage (unilateral) 30-Sep-08 2
32998 Ablation therapy for reduction or eradication of 1 or more pulmonary tumor(s) 30-Sep-08 2
including pleura or chest wall when involved by tumor extension, percutaneous,
radiofrequency, unilateral
32999 Unlisted procedure, lungs and pleura 30-Sep-08
33010 Pericardiocentesis; initial 30-Sep-08 1

33011 Pericardiocentesis; subsequent 30-Sep-08 1
33015 Tube pericardiostomy 30-Sep-08 1
33020 Pericardiotomy for removal of clot or foreign body (primary procedure) 30-Sep-08 1
33025 Creation of pericardial window or partial resection for drainage 30-Sep-08 1

33030 Pericardiectomy, subtotal or complete; without cardiopulmonary bypass 30-Sep-08 1
33031 Pericardiectomy, subtotal or complete; with cardiopulmonary bypass 30-Sep-08 1

33050 Excision of pericardial cyst or tumor 30-Sep-08 1
33120 Excision of intracardiac tumor, resection with cardiopulmonary bypass 30-Sep-08 1
33130 Resection of external cardiac tumor 30-Sep-08 1
33140 Transmyocardial laser revascularization, by thoracotomy; (separate procedure) 30-Sep-08 1
33141 Transmyocardial laser revascularization, by thoracotomy; performed at the time 30-Sep-08 1

of other open cardiac procedure(s) (List separately in addition to code for
primary procedure)
33202 Insertion of epicardial electrode(s); open incision (eg, thoracotomy, median 30-Sep-08 1
sternotomy, subxiphoid approach)
33203 Insertion of epicardial electrode(s); endoscopic approach (eg, thoracoscopy, 30-Sep-08 1
pericardioscopy)
33206 Insertion or replacement of permanent pacemaker with transvenous 30-Sep-08 1
electrode(s); atrial
electrode(s); ventricular
electrode(s); atrial and ventricular
33210 Insertion or replacement of temporary transvenous single chamber cardiac 30-Sep-08 1
electrode or pacemaker catheter (separate procedure)
33211 Insertion or replacement of temporary transvenous dual chamber pacing 30-Sep-08 1
electrodes (separate procedure)
33212 Insertion or replacement of pacemaker pulse generator only; single chamber, 30-Sep-08 1
atrial or ventricular
33213 Insertion or replacement of pacemaker pulse generator only; dual chamber 30-Sep-08 1
33214 Upgrade of implanted pacemaker system, conversion of single chamber system 30-Sep-08 1
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 pacing 30-Sep-08 2

cardioverter-defibrillator (right atrial or right ventricular) electrode
33216 Insertion of a single transvenous electrode, permanent pacemaker or 30-Sep-08 1

cardioverter-defibrillator
33217 Insertion of 2 transvenous electrodes, permanent pacemaker or cardioverter- 30-Sep-08 1
defibrillator
33218 Repair of single transvenous electrode for a single chamber, permanent 30-Sep-08 1
pacemaker or single chamber pacing cardioverter-defibrillator
33220 Repair of 2 transvenous electrodes for a dual chamber permanent pacemaker or 30-Sep-08 1
dual chamber pacing cardioverter-defibrillator
33222 Revision or relocation of skin pocket for pacemaker 30-Sep-08 1
33223 Revision of skin pocket for cardioverter-defibrillator 30-Sep-08 1
33224 Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, 30-Sep-08 1
with attachment to previously placed pacemaker or pacing cardioverter-
defibrillator pulse generator (including revision of pocket, removal, insertion,
and/or replacement of generator)
33225 Insertion of pacing electrode, cardiac venous system, for left ventricular pacing, 30-Sep-08 1
at time of insertion of pacing cardioverter-defibrillator or pacemaker pulse
generator (including upgrade to dual chamber system) (List separately in
33226 Repositioning of previously implanted cardiac venous system (left ventricular) 30-Sep-08 1
electrode (including removal, insertion and/or replacement of generator)
33233 Removal of permanent pacemaker pulse generator 30-Sep-08 1

33234 Removal of transvenous pacemaker electrode(s); single lead system, atrial or 30-Sep-08 1
ventricular
33235 Removal of transvenous pacemaker electrode(s); dual lead system 30-Sep-08 1
33236 Removal of permanent epicardial pacemaker and electrodes by thoracotomy; 30-Sep-08 1
single lead system, atrial or ventricular
33237 Removal of permanent epicardial pacemaker and electrodes by thoracotomy; 30-Sep-08 1
dual lead system
33238 Removal of permanent transvenous electrode(s) by thoracotomy 30-Sep-08 1
33240 Insertion of single or dual chamber pacing cardioverter-defibrillator pulse 30-Sep-08 1
generator
33241 Subcutaneous removal of single or dual chamber pacing cardioverter-defibrillator 30-Sep-08 1
pulse generator
33243 Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s); 30-Sep-08 1
by thoracotomy
33244 Removal of single or dual chamber pacing cardioverter-defibrillator electrode(s); 30-Sep-08 1
by transvenous extraction
33249 Insertion or repositioning of electrode lead(s) for single or dual chamber pacing 30-Sep-08 1
cardioverter-defibrillator and insertion of pulse generator
33250 Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, 30-Sep-08 1

Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus
(foci); without cardiopulmonary bypass
33251 Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, 30-Sep-08 1
Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) and/or focus
(foci); with cardiopulmonary bypass
33254 Operative tissue ablation and reconstruction of atria, limited (eg, modified maze 30-Sep-08 1
procedure)
33255 Operative tissue ablation and reconstruction of atria, extensive (eg, maze 30-Sep-08 1
procedure); without cardiopulmonary bypass
33256 Operative tissue ablation and reconstruction of atria, extensive (eg, maze 30-Sep-08 1
procedure); with cardiopulmonary bypass
33257 Operative tissue ablation and reconstruction of atria, performed at the time of 30-Sep-08 1
other cardiac procedure(s), limited (eg, modified maze procedure) (List
other cardiac procedure(s), extensive (eg, maze procedure), without
cardiopulmonary bypass (List separately in addition to code for primary
procedure)
other cardiac procedure(s), extensive (eg, maze procedure), with
cardiopulmonary bypass (List separately in addition to code for primary
procedure)
33261 Operative ablation of ventricular arrhythmogenic focus with cardiopulmonary 30-Sep-08 1
bypass
33265 Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited 30-Sep-08 1
(eg, modified maze procedure), without cardiopulmonary bypass
33266 Endoscopy, surgical; operative tissue ablation and reconstruction of atria, 30-Sep-08 1
extensive (eg, maze procedure), without cardiopulmonary bypass
33282 Implantation of patient-activated cardiac event recorder 30-Sep-08 1

33284 Removal of an implantable, patient-activated cardiac event recorder 30-Sep-08 1
33300 Repair of cardiac wound; without bypass 30-Sep-08 1
33305 Repair of cardiac wound; with cardiopulmonary bypass 30-Sep-08 1
33310 Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular 30-Sep-08 1
thrombus); without bypass
33315 Cardiotomy, exploratory (includes removal of foreign body, atrial or ventricular 30-Sep-08 1
thrombus); with cardiopulmonary bypass
33320 Suture repair of aorta or great vessels; without shunt or cardiopulmonary bypass 30-Sep-08 1
33321 Suture repair of aorta or great vessels; with shunt bypass 30-Sep-08 1
33322 Suture repair of aorta or great vessels; with cardiopulmonary bypass 30-Sep-08 1
33330 Insertion of graft, aorta or great vessels; without shunt, or cardiopulmonary 30-Sep-08 1
bypass
33332 Insertion of graft, aorta or great vessels; with shunt bypass 30-Sep-08 1
33335 Insertion of graft, aorta or great vessels; with cardiopulmonary bypass 30-Sep-08 1
33400 Valvuloplasty, aortic valve; open, with cardiopulmonary bypass 30-Sep-08 1
33401 Valvuloplasty, aortic valve; open, with inflow occlusion 30-Sep-08 1
33403 Valvuloplasty, aortic valve; using transventricular dilation, with cardiopulmonary 30-Sep-08 1
bypass
33404 Construction of apical-aortic conduit 30-Sep-08 1
33405 Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic valve 30-Sep-08 1
other than homograft or stentless valve
33406 Replacement, aortic valve, with cardiopulmonary bypass; with allograft valve 30-Sep-08 1
(freehand)
33410 Replacement, aortic valve, with cardiopulmonary bypass; with stentless tissue 30-Sep-08 1
valve
33411 Replacement, aortic valve; with aortic annulus enlargement, noncoronary sinus 30-Sep-08 1
33412 Replacement, aortic valve; with transventricular aortic annulus enlargement 30-Sep-08 1
(Konno procedure)
33413 Replacement, aortic valve; by translocation of autologous pulmonary valve with 30-Sep-08 1
allograft replacement of pulmonary valve (Ross procedure)
33414 Repair of left ventricular outflow tract obstruction by patch enlargement of the 30-Sep-08 1
outflow tract
33415 Resection or incision of subvalvular tissue for discrete subvalvular aortic stenosis 30-Sep-08 1
33416 Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic stenosis 30-Sep-08 1

(eg, asymmetric septal hypertrophy)
33417 Aortoplasty (gusset) for supravalvular stenosis 30-Sep-08 1
33420 Valvotomy, mitral valve; closed heart 30-Sep-08 1
33422 Valvotomy, mitral valve; open heart, with cardiopulmonary bypass 30-Sep-08 1
33425 Valvuloplasty, mitral valve, with cardiopulmonary bypass; 30-Sep-08 1
33426 Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic ring 30-Sep-08 1
33427 Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical reconstruction, 30-Sep-08 1
with or without ring
33430 Replacement, mitral valve, with cardiopulmonary bypass 30-Sep-08 1
33460 Valvectomy, tricuspid valve, with cardiopulmonary bypass 30-Sep-08 1
33463 Valvuloplasty, tricuspid valve; without ring insertion 30-Sep-08 1
33464 Valvuloplasty, tricuspid valve; with ring insertion 30-Sep-08 1
33465 Replacement, tricuspid valve, with cardiopulmonary bypass 30-Sep-08 1
33468 Tricuspid valve repositioning and plication for Ebstein anomaly 30-Sep-08 1
33470 Valvotomy, pulmonary valve, closed heart; transventricular 30-Sep-08 1
33471 Valvotomy, pulmonary valve, closed heart; via pulmonary artery 30-Sep-08 1
33472 Valvotomy, pulmonary valve, open heart; with inflow occlusion 30-Sep-08 1
33474 Valvotomy, pulmonary valve, open heart; with cardiopulmonary bypass 30-Sep-08 1
33475 Replacement, pulmonary valve 30-Sep-08 1

33476 Right ventricular resection for infundibular stenosis, with or without 30-Sep-08 1
commissurotomy
33478 Outflow tract augmentation (gusset), with or without commissurotomy or 30-Sep-08 1
infundibular resection
33496 Repair of non-structural prosthetic valve dysfunction with cardiopulmonary 30-Sep-08 1
bypass (separate procedure)
33500 Repair of coronary arteriovenous or arteriocardiac chamber fistula; with 30-Sep-08 1
33501 Repair of coronary arteriovenous or arteriocardiac chamber fistula; without 30-Sep-08 1
33502 Repair of anomalous coronary artery from pulmonary artery origin; by ligation 30-Sep-08 1
33503 Repair of anomalous coronary artery from pulmonary artery origin; by graft, 30-Sep-08 1
without cardiopulmonary bypass
33504 Repair of anomalous coronary artery from pulmonary artery origin; by graft, with 30-Sep-08 1
33505 Repair of anomalous coronary artery from pulmonary artery origin; with 30-Sep-08 1
construction of intrapulmonary artery tunnel (Takeuchi procedure)
33506 Repair of anomalous coronary artery from pulmonary artery origin; by 30-Sep-08 1
translocation from pulmonary artery to aorta
33507 Repair of anomalous (eg, intramural) aortic origin of coronary artery by unroofing 30-Sep-08 1
or translocation
33508 Endoscopy, surgical, including video-assisted harvest of vein(s) for coronary 30-Sep-08 1
artery bypass procedure (List separately in addition to code for primary
procedure)
33510 Coronary artery bypass, vein only; single coronary venous graft 30-Sep-08 1
33511 Coronary artery bypass, vein only; 2 coronary venous grafts 30-Sep-08 1
33516 Coronary artery bypass, vein only; 6 or more coronary venous grafts 30-Sep-08 1
33517 Coronary artery bypass, using venous graft(s) and arterial graft(s); single vein 30-Sep-08 1
graft (List separately in addition to code for primary procedure)
33518 Coronary artery bypass, using venous graft(s) and arterial graft(s); 2 venous 30-Sep-08 1
grafts (List separately in addition to code for primary procedure)
33523 Coronary artery bypass, using venous graft(s) and arterial graft(s); 6 or more 30-Sep-08 1
venous grafts (List separately in addition to code for primary procedure)
33530 Reoperation, coronary artery bypass procedure or valve procedure, more than 1 30-Sep-08 1
month after original operation (List separately in addition to code for primary
procedure)
33533 Coronary artery bypass, using arterial graft(s); single arterial graft 30-Sep-08 1
33534 Coronary artery bypass, using arterial graft(s); 2 coronary arterial grafts 30-Sep-08 1
33535 Coronary artery bypass, using arterial graft(s); 3 coronary arterial grafts 30-Sep-08 1
33536 Coronary artery bypass, using arterial graft(s); 4 or more coronary arterial grafts 30-Sep-08 1
33542 Myocardial resection (eg, ventricular aneurysmectomy) 30-Sep-08 1

33545 Repair of postinfarction ventricular septal defect, with or without myocardial 30-Sep-08 1
resection
33548 Surgical ventricular restoration procedure, includes prosthetic patch, when 30-Sep-08 1
performed (eg, ventricular remodeling, SVR, SAVER, Dor procedures)
33572 Coronary endarterectomy, open, any method, of left anterior descending, 30-Sep-08 3
circumflex, or right coronary artery performed in conjunction with coronary
artery bypass graft procedure, each vessel (List separately in addition to primary
procedure)
33600 Closure of atrioventricular valve (mitral or tricuspid) by suture or patch 30-Sep-08
33602 Closure of semilunar valve (aortic or pulmonary) by suture or patch 30-Sep-08

33606 Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel procedure) 30-Sep-08 1
33608 Repair of complex cardiac anomaly other than pulmonary atresia with ventricular 30-Sep-08 1
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 30-Sep-08 1
obstruction) by surgical enlargement of ventricular septal defect
33611 Repair of double outlet right ventricle with intraventricular tunnel repair; 30-Sep-08 1
33612 Repair of double outlet right ventricle with intraventricular tunnel repair; with 30-Sep-08 1
repair of right ventricular outflow tract obstruction
33615 Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial 30-Sep-08 1
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 30-Sep-08 1
procedure
33619 Repair of single ventricle with aortic outflow obstruction and aortic arch 30-Sep-08 1
hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure)
33620 Application of right and left pulmonary artery bands (eg, hybrid approach stage 15-Oct-12 1
1)
33621 Transthoracic insertion of catheter for stent placement with catheter removal 15-Oct-12 1
and closure (eg, hybrid approach stage 1)
33622 Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic 15-Oct-12 1
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)
33641 Repair atrial septal defect, secundum, with cardiopulmonary bypass, with or 30-Sep-08 1
without patch
33645 Direct or patch closure, sinus venosus, with or without anomalous pulmonary 30-Sep-08 1
venous drainage
33647 Repair of atrial septal defect and ventricular septal defect, with direct or patch 30-Sep-08 1
closure
33660 Repair of incomplete or partial atrioventricular canal (ostium primum atrial 30-Sep-08 1
septal defect), with or without atrioventricular valve repair
33665 Repair of intermediate or transitional atrioventricular canal, with or without 30-Sep-08
atrioventricular valve repair
33670 Repair of complete atrioventricular canal, with or without prosthetic valve 30-Sep-08
33675 Closure of multiple ventricular septal defects; 30-Sep-08 1

33676 Closure of multiple ventricular septal defects; with pulmonary valvotomy or 30-Sep-08
infundibular resection (acyanotic)
33677 Closure of multiple ventricular septal defects; with removal of pulmonary artery 30-Sep-08
band, with or without gusset
33681 Closure of single ventricular septal defect, with or without patch; 30-Sep-08 1
33684 Closure of single ventricular septal defect, with or without patch; with pulmonary 30-Sep-08 1
valvotomy or infundibular resection (acyanotic)
33688 Closure of single ventricular septal defect, with or without patch; with removal of 30-Sep-08 1
pulmonary artery band, with or without gusset
33690 Banding of pulmonary artery 30-Sep-08 1
33692 Complete repair tetralogy of Fallot without pulmonary atresia; 30-Sep-08 1
33694 Complete repair tetralogy of Fallot without pulmonary atresia; with transannular 30-Sep-08 1
patch
33697 Complete repair tetralogy of Fallot with pulmonary atresia including construction 30-Sep-08 1
of conduit from right ventricle to pulmonary artery and closure of ventricular
septal defect
33702 Repair sinus of Valsalva fistula, with cardiopulmonary bypass; 30-Sep-08 1
33710 Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair of 30-Sep-08 1
ventricular septal defect
33720 Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass 30-Sep-08 1
33722 Closure of aortico-left ventricular tunnel 30-Sep-08 1
33724 Repair of isolated partial anomalous pulmonary venous return (eg, Scimitar 30-Sep-08 1
Syndrome)
33726 Repair of pulmonary venous stenosis 30-Sep-08
33730 Complete repair of anomalous pulmonary venous return (supracardiac, 30-Sep-08 1
intracardiac, or infracardiac types)
33732 Repair of cor triatriatum or supravalvular mitral ring by resection of left atrial 30-Sep-08 1
membrane
33735 Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type operation) 30-Sep-08 1
33736 Atrial septectomy or septostomy; open heart with cardiopulmonary bypass 30-Sep-08 1
33737 Atrial septectomy or septostomy; open heart, with inflow occlusion 30-Sep-08 1
33750 Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) 30-Sep-08 1
33755 Shunt; ascending aorta to pulmonary artery (Waterston type operation) 30-Sep-08 1
33762 Shunt; descending aorta to pulmonary artery (Potts-Smith type operation) 30-Sep-08 1
33764 Shunt; central, with prosthetic graft 30-Sep-08 1

33766 Shunt; superior vena cava to pulmonary artery for flow to 1 lung (classical Glenn 30-Sep-08 1
procedure)
33767 Shunt; superior vena cava to pulmonary artery for flow to both lungs 30-Sep-08 1
(bidirectional Glenn procedure)
33768 Anastomosis, cavopulmonary, second superior vena cava (List separately in 30-Sep-08 1
addition to primary procedure)
33770 Repair of transposition of the great arteries with ventricular septal defect and 30-Sep-08 1
subpulmonary stenosis; without surgical enlargement of ventricular septal defect
33771 Repair of transposition of the great arteries with ventricular septal defect and 30-Sep-08 1
subpulmonary stenosis; with surgical enlargement of ventricular septal defect
33774 Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard 30-Sep-08 1
or Senning type) with cardiopulmonary bypass;
or Senning type) with cardiopulmonary bypass; with removal of pulmonary band
or Senning type) with cardiopulmonary bypass; with closure of ventricular septal
defect
or Senning type) with cardiopulmonary bypass; with repair of subpulmonic
obstruction
33778 Repair of transposition of the great arteries, aortic pulmonary artery 30-Sep-08 1
reconstruction (eg, Jatene type);
reconstruction (eg, Jatene type); with removal of pulmonary band
reconstruction (eg, Jatene type); with closure of ventricular septal defect
reconstruction (eg, Jatene type); with repair of subpulmonic obstruction
33782 Aortic root translocation with ventricular septal defect and pulmonary stenosis 15-Oct-12
repair (ie, Nikaidoh procedure); without coronary ostium reimplantation
33783 Aortic root translocation with ventricular septal defect and pulmonary stenosis 15-Oct-12
repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia
33786 Total repair, truncus arteriosus (Rastelli type operation) 30-Sep-08 1

33788 Reimplantation of an anomalous pulmonary artery 30-Sep-08 1
33800 Aortic suspension (aortopexy) for tracheal decompression (eg, for 30-Sep-08 1
tracheomalacia) (separate procedure)
33802 Division of aberrant vessel (vascular ring); 30-Sep-08 1
33803 Division of aberrant vessel (vascular ring); with reanastomosis 30-Sep-08 1
33813 Obliteration of aortopulmonary septal defect; without cardiopulmonary bypass 30-Sep-08 1
33814 Obliteration of aortopulmonary septal defect; with cardiopulmonary bypass 30-Sep-08 1
33820 Repair of patent ductus arteriosus; by ligation 30-Sep-08 1

33822 Repair of patent ductus arteriosus; by division, younger than 18 years 30-Sep-08 1
33824 Repair of patent ductus arteriosus; by division, 18 years and older 30-Sep-08 1
33840 Excision of coarctation of aorta, with or without associated patent ductus 30-Sep-08 1
arteriosus; with direct anastomosis
arteriosus; with graft
arteriosus; 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 30-Sep-08 1
material; without cardiopulmonary bypass
33853 Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic 30-Sep-08 1
material; with cardiopulmonary bypass
33860 Ascending aorta graft, with cardiopulmonary bypass, includes valve suspension, 30-Sep-08 1
when performed
33861 Ascending aorta graft, with cardiopulmonary bypass, with or without valve 30-Sep-08 14-Oct-12
suspension; with coronary reconstruction
33863 Ascending aorta graft, with cardiopulmonary bypass, with aortic root 30-Sep-08 1
replacement using valved conduit and coronary reconstruction (eg, Bentall)
33864 Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with 30-Sep-08 1
coronary reconstruction and valve-sparing aortic root remodeling (eg, David
Procedure, Yacoub Procedure)
33870 Transverse arch graft, with cardiopulmonary bypass 30-Sep-08 1
33875 Descending thoracic aorta graft, with or without bypass 30-Sep-08 1
33877 Repair of thoracoabdominal aortic aneurysm with graft, with or without 30-Sep-08 1
33880 Endovascular repair of descending thoracic aorta (eg, aneurysm, 30-Sep-08 1
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

traumatic disruption); not involving coverage of left subclavian artery origin,
initial endoprosthesis plus descending thoracic aortic extension(s), if required, to
level of celiac artery origin
33883 Placement of proximal extension prosthesis for endovascular repair of 30-Sep-08 1

descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection,
penetrating ulcer, intramural hematoma, or traumatic disruption); initial
extension
penetrating ulcer, intramural hematoma, or traumatic disruption); each
additional proximal extension (List separately in addition to code for primary
procedure)
33886 Placement of distal extension prosthesis(s) delayed after endovascular repair of 30-Sep-08 1
descending thoracic aorta
33889 Open subclavian to carotid artery transposition performed in conjunction with 30-Sep-08 1
endovascular repair of descending thoracic aorta, by neck incision, unilateral
33891 Bypass graft, with other than vein, transcervical retropharyngeal carotid-carotid, 30-Sep-08 1
performed in conjunction with endovascular repair of descending thoracic aorta,
by neck incision
33910 Pulmonary artery embolectomy; with cardiopulmonary bypass 30-Sep-08 1
33915 Pulmonary artery embolectomy; without cardiopulmonary bypass 30-Sep-08 1
33916 Pulmonary endarterectomy, with or without embolectomy, with cardiopulmonary 30-Sep-08 1
bypass
33917 Repair of pulmonary artery stenosis by reconstruction with patch or graft 30-Sep-08 1
33920 Repair of pulmonary atresia with ventricular septal defect, by construction or 30-Sep-08 1
replacement of conduit from right or left ventricle to pulmonary artery
33922 Transection of pulmonary artery with cardiopulmonary bypass 30-Sep-08 1

33924 Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in 30-Sep-08 1
conjunction with a congenital heart procedure (List separately in addition to
33925 Repair of pulmonary artery arborization anomalies by unifocalization; without 30-Sep-08 1
33926 Repair of pulmonary artery arborization anomalies by unifocalization; with 30-Sep-08 1
33930 Donor cardiectomy-pneumonectomy (including cold preservation) 30-Sep-08 1
33933 Backbench standard preparation of cadaver donor heart/lung allograft prior to 30-Sep-08 1
prepare aorta, superior vena cava, inferior vena cava, and trachea for
implantation
33935 Heart-lung transplant with recipient cardiectomy-pneumonectomy 30-Sep-08 1
33940 Donor cardiectomy (including cold preservation) 30-Sep-08 1
33944 Backbench standard preparation of cadaver donor heart allograft prior to 30-Sep-08 1
prepare aorta, superior vena cava, inferior vena cava, pulmonary artery, and left
atrium for implantation
33945 Heart transplant, with or without recipient cardiectomy 30-Sep-08 1
33960 Prolonged extracorporeal circulation for cardiopulmonary insufficiency; initial 24 30-Sep-08 1
hours
33961 Prolonged extracorporeal circulation for cardiopulmonary insufficiency; each 30-Sep-08 1
additional 24 hours (List separately in addition to code for primary procedure)
33967 Insertion of intra-aortic balloon assist device, percutaneous 30-Sep-08 1

33968 Removal of intra-aortic balloon assist device, percutaneous 30-Sep-08 1
33970 Insertion of intra-aortic balloon assist device through the femoral artery, open 30-Sep-08 1
approach
33971 Removal of intra-aortic balloon assist device including repair of femoral artery, 30-Sep-08 1
with or without graft
33973 Insertion of intra-aortic balloon assist device through the ascending aorta 30-Sep-08 1
33974 Removal of intra-aortic balloon assist device from the ascending aorta, including 30-Sep-08 1
repair of the ascending aorta, with or without graft
33975 Insertion of ventricular assist device; extracorporeal, single ventricle 30-Sep-08 1
33976 Insertion of ventricular assist device; extracorporeal, biventricular 30-Sep-08 1
33977 Removal of ventricular assist device; extracorporeal, single ventricle 30-Sep-08 1
33978 Removal of ventricular assist device; extracorporeal, biventricular 30-Sep-08 1
33979 Insertion of ventricular assist device, implantable intracorporeal, single ventricle 30-Sep-08 2
33980 Removal of ventricular assist device, implantable intracorporeal, single ventricle 30-Sep-08 2
33981 Replacement of extracorporeal ventricular assist device, single or biventricular, 15-Oct-12

pump(s), single or each pump
33982 Replacement of ventricular assist device pump(s); implantable intracorporeal, 15-Oct-12
single ventricle, without cardiopulmonary bypass
33983 Replacement of ventricular assist device pump(s); implantable intracorporeal, 15-Oct-12
single ventricle, with cardiopulmonary bypass
33999 Unlisted procedure, cardiac surgery 30-Sep-08
34001 Embolectomy or thrombectomy, with or without catheter; carotid, subclavian or 30-Sep-08 1

innominate artery, by neck incision
34051 Embolectomy or thrombectomy, with or without catheter; innominate, 30-Sep-08 1
subclavian artery, by thoracic incision
34101 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, 30-Sep-08 2
innominate, subclavian artery, by arm incision
34111 Embolectomy or thrombectomy, with or without catheter; radial or ulnar artery, 30-Sep-08 2
by arm incision
34151 Embolectomy or thrombectomy, with or without catheter; renal, celiac, 30-Sep-08 2
mesentery, aortoiliac artery, by abdominal incision
34201 Embolectomy or thrombectomy, with or without catheter; femoropopliteal, 30-Sep-08 2
aortoiliac artery, by leg incision
34203 Embolectomy or thrombectomy, with or without catheter; popliteal-tibio- 30-Sep-08 2
peroneal artery, by leg incision
34401 Thrombectomy, direct or with catheter; vena cava, iliac vein, by abdominal 30-Sep-08 1
incision
34421 Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by 30-Sep-08 2
leg incision
34451 Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, by 30-Sep-08 1
abdominal and leg incision
34471 Thrombectomy, direct or with catheter; subclavian vein, by neck incision 30-Sep-08 1
34490 Thrombectomy, direct or with catheter; axillary and subclavian vein, by arm 30-Sep-08 2
incision
34501 Valvuloplasty, femoral vein 30-Sep-08 2
34502 Reconstruction of vena cava, any method 30-Sep-08
34510 Venous valve transposition, any vein donor 30-Sep-08 2
34520 Cross-over vein graft to venous system 30-Sep-08 1
34530 Saphenopopliteal vein anastomosis 30-Sep-08 2
34800 Endovascular repair of infrarenal abdominal aortic aneurysm or dissection; using 30-Sep-08 1
aorto-aortic tube prosthesis
modular bifurcated prosthesis (1 docking limb)
modular bifurcated prosthesis (2 docking limbs)
unibody bifurcated prosthesis
aorto-uniiliac or aorto-unifemoral prosthesis
34806 Transcatheter placement of wireless physiologic sensor in aneurysmal sac during 30-Sep-08 1
endovascular repair, including radiological supervision and interpretation,
instrument calibration, and collection of pressure data (List separately in
34808 Endovascular placement of iliac artery occlusion device (List separately in 30-Sep-08 1
34812 Open femoral artery exposure for delivery of endovascular prosthesis, by groin 30-Sep-08 1
incision, unilateral
34813 Placement of femoral-femoral prosthetic graft during endovascular aortic 30-Sep-08 1
aneurysm repair (List separately in addition to code for primary procedure)
34820 Open iliac artery exposure for delivery of endovascular prosthesis or iliac 30-Sep-08 1
occlusion during endovascular therapy, by abdominal or retroperitoneal incision,
unilateral
34825 Placement of proximal or distal extension prosthesis for endovascular repair of 30-Sep-08 2
infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection;
initial vessel
infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection;
each additional vessel (List separately in addition to code for primary procedure)
34830 Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated 30-Sep-08 1
arterial trauma, following unsuccessful endovascular repair; tube prosthesis
arterial trauma, following unsuccessful endovascular repair; aorto-bi-iliac
prosthesis
arterial trauma, following unsuccessful endovascular repair; aorto-bifemoral
prosthesis
34833 Open iliac artery exposure with creation of conduit for delivery of aortic or iliac 30-Sep-08 1
endovascular prosthesis, by abdominal or retroperitoneal incision, unilateral
34834 Open brachial artery exposure to assist in the deployment of aortic or iliac 30-Sep-08 1
endovascular prosthesis by arm incision, unilateral
34900 Endovascular repair of iliac artery (eg, aneurysm, pseudoaneurysm, 30-Sep-08 2
arteriovenous malformation, trauma) using ilio-iliac tube endoprosthesis
35001 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and 30-Sep-08 2
graft insertion, with or without patch graft; for aneurysm and associated
occlusive disease, carotid, subclavian artery, by neck incision
graft insertion, with or without patch graft; for ruptured aneurysm, carotid,
subclavian artery, by neck incision
graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and
associated occlusive disease, vertebral artery
graft insertion, with or without patch graft; for aneurysm and associated
occlusive disease, axillary-brachial artery, by arm incision
graft insertion, with or without patch graft; for ruptured aneurysm, axillary-
brachial artery, by arm incision
associated occlusive disease, innominate, subclavian artery, by thoracic incision
graft insertion, with or without patch graft; for ruptured aneurysm, innominate,
subclavian artery, by thoracic incision
associated occlusive disease, radial or ulnar artery
associated occlusive disease, abdominal aorta
graft insertion, with or without patch graft; for ruptured aneurysm, abdominal
aorta
associated occlusive disease, abdominal aorta involving visceral vessels
(mesenteric, celiac, renal)
aorta involving visceral vessels (mesenteric, celiac, renal)
associated occlusive disease, abdominal aorta involving iliac vessels (common,
hypogastric, external)
aorta involving iliac vessels (common, hypogastric, external)
associated occlusive disease, splenic artery
graft insertion, with or without patch graft; for ruptured aneurysm, splenic artery
associated occlusive disease, hepatic, celiac, renal, or mesenteric artery
graft insertion, with or without patch graft; for ruptured aneurysm, hepatic,
celiac, renal, or mesenteric artery
associated occlusive disease, iliac artery (common, hypogastric, external)
graft insertion, with or without patch graft; for ruptured aneurysm, iliac artery
(common, hypogastric, external)
associated occlusive disease, common femoral artery (profunda femoris,
superficial femoral)
graft insertion, with or without patch graft; for ruptured aneurysm, common
femoral artery (profunda femoris, superficial femoral)
associated occlusive disease, popliteal artery
graft insertion, with or without patch graft; for ruptured aneurysm, popliteal
artery
35180 Repair, congenital arteriovenous fistula; head and neck 30-Sep-08 2
35182 Repair, congenital arteriovenous fistula; thorax and abdomen 30-Sep-08 2
35184 Repair, congenital arteriovenous fistula; extremities 30-Sep-08 2
35188 Repair, acquired or traumatic arteriovenous fistula; head and neck 30-Sep-08 2
35189 Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen 30-Sep-08 1
35190 Repair, acquired or traumatic arteriovenous fistula; extremities 30-Sep-08 2

35201 Repair blood vessel, direct; neck 30-Sep-08 2
35206 Repair blood vessel, direct; upper extremity 30-Sep-08 2
35207 Repair blood vessel, direct; hand, finger 30-Sep-08 3
35211 Repair blood vessel, direct; intrathoracic, with bypass 30-Sep-08 3
35216 Repair blood vessel, direct; intrathoracic, without bypass 30-Sep-08 3
35221 Repair blood vessel, direct; intra-abdominal 30-Sep-08 3
35226 Repair blood vessel, direct; lower extremity 30-Sep-08 3
35231 Repair blood vessel with vein graft; neck 30-Sep-08 2
35236 Repair blood vessel with vein graft; upper extremity 30-Sep-08 2
35241 Repair blood vessel with vein graft; intrathoracic, with bypass 30-Sep-08 2
35246 Repair blood vessel with vein graft; intrathoracic, without bypass 30-Sep-08 2
35251 Repair blood vessel with vein graft; intra-abdominal 30-Sep-08 2
35256 Repair blood vessel with vein graft; lower extremity 30-Sep-08 2
35261 Repair blood vessel with graft other than vein; neck 30-Sep-08 1
35266 Repair blood vessel with graft other than vein; upper extremity 30-Sep-08 2
35271 Repair blood vessel with graft other than vein; intrathoracic, with bypass 30-Sep-08 2
35276 Repair blood vessel with graft other than vein; intrathoracic, without bypass 30-Sep-08 2
35281 Repair blood vessel with graft other than vein; intra-abdominal 30-Sep-08 2
35286 Repair blood vessel with graft other than vein; lower extremity 30-Sep-08 2
35301 Thromboendarterectomy, including patch graft, if performed; carotid, vertebral, 30-Sep-08
subclavian, by neck incision
35302 Thromboendarterectomy, including patch graft, if performed; superficial femoral 30-Sep-08 2
artery
35303 Thromboendarterectomy, including patch graft, if performed; popliteal artery 30-Sep-08 2
35304 Thromboendarterectomy, including patch graft, if performed; tibioperoneal trunk 30-Sep-08 2

artery
35305 Thromboendarterectomy, including patch graft, if performed; tibial or peroneal 30-Sep-08 2
artery, initial vessel
35306 Thromboendarterectomy, including patch graft, if performed; each additional 30-Sep-08 2
tibial or peroneal artery (List separately in addition to code for primary
procedure)
35311 Thromboendarterectomy, including patch graft, if performed; subclavian, 30-Sep-08 2
innominate, by thoracic incision
35321 Thromboendarterectomy, including patch graft, if performed; axillary-brachial 30-Sep-08 2
35331 Thromboendarterectomy, including patch graft, if performed; abdominal aorta 30-Sep-08 1
35341 Thromboendarterectomy, including patch graft, if performed; mesenteric, celiac, 30-Sep-08

or renal
35351 Thromboendarterectomy, including patch graft, if performed; iliac 30-Sep-08 2
35355 Thromboendarterectomy, including patch graft, if performed; iliofemoral 30-Sep-08 2
35361 Thromboendarterectomy, including patch graft, if performed; combined aortoiliac 30-Sep-08 1
35363 Thromboendarterectomy, including patch graft, if performed; combined 30-Sep-08 1

aortoiliofemoral
35371 Thromboendarterectomy, including patch graft, if performed; common femoral 30-Sep-08 2
35372 Thromboendarterectomy, including patch graft, if performed; deep (profunda) 30-Sep-08 2

femoral
35390 Reoperation, carotid, thromboendarterectomy, more than 1 month after original 30-Sep-08 2
operation (List separately in addition to code for primary procedure)
35400 Angioscopy (non-coronary vessels or grafts) during therapeutic intervention (List 30-Sep-08 1
35450 Transluminal balloon angioplasty, open; renal or other visceral artery 30-Sep-08 2
35452 Transluminal balloon angioplasty, open; aortic 30-Sep-08 1
35454 Transluminal balloon angioplasty, open; iliac 30-Sep-08 14-Oct-12
35456 Transluminal balloon angioplasty, open; femoral-popliteal 30-Sep-08 14-Oct-12
35458 Transluminal balloon angioplasty, open; brachiocephalic trunk or branches, each 30-Sep-08 3
vessel
35459 Transluminal balloon angioplasty, open; tibioperoneal trunk and branches 30-Sep-08 14-Oct-12
35460 Transluminal balloon angioplasty, open; venous 30-Sep-08

35470 Transluminal balloon angioplasty, percutaneous; tibioperoneal trunk or branches, 30-Sep-08 14-Oct-12
each vessel
35471 Transluminal balloon angioplasty, percutaneous; renal or visceral artery 30-Sep-08 3
35472 Transluminal balloon angioplasty, percutaneous; aortic 30-Sep-08 1

35473 Transluminal balloon angioplasty, percutaneous; iliac 30-Sep-08 14-Oct-12
35474 Transluminal balloon angioplasty, percutaneous; femoral-popliteal 30-Sep-08 14-Oct-12
35475 Transluminal balloon angioplasty, percutaneous; brachiocephalic trunk or 30-Sep-08
branches, each vessel
35476 Transluminal balloon angioplasty, percutaneous; venous 30-Sep-08
35480 Transluminal peripheral atherectomy, open; renal or other visceral artery 30-Sep-08 14-Oct-12
35481 Transluminal peripheral atherectomy, open; aortic 30-Sep-08 14-Oct-12

35482 Transluminal peripheral atherectomy, open; iliac 30-Sep-08 14-Oct-12
35483 Transluminal peripheral atherectomy, open; femoral-popliteal 30-Sep-08 14-Oct-12
35484 Transluminal peripheral atherectomy, open; brachiocephalic trunk or branches, 30-Sep-08 14-Oct-12
each vessel
35485 Transluminal peripheral atherectomy, open; tibioperoneal trunk and branches 30-Sep-08 14-Oct-12
35490 Transluminal peripheral atherectomy, percutaneous; renal or other visceral 30-Sep-08 14-Oct-12
artery
35491 Transluminal peripheral atherectomy, percutaneous; aortic 30-Sep-08 14-Oct-12
35492 Transluminal peripheral atherectomy, percutaneous; iliac 30-Sep-08 14-Oct-12
35493 Transluminal peripheral atherectomy, percutaneous; femoral-popliteal 30-Sep-08 14-Oct-12
35494 Transluminal peripheral atherectomy, percutaneous; brachiocephalic trunk or 30-Sep-08 14-Oct-12

branches, each vessel
35495 Transluminal peripheral atherectomy, percutaneous; tibioperoneal trunk and 30-Sep-08 14-Oct-12
branches
35500 Harvest of upper extremity vein, 1 segment, for lower extremity or coronary 30-Sep-08 2
artery bypass procedure (List separately in addition to code for primary
procedure)
35501 Bypass graft, with vein; common carotid-ipsilateral internal carotid 30-Sep-08 2
35506 Bypass graft, with vein; carotid-subclavian or subclavian-carotid 30-Sep-08 1
35508 Bypass graft, with vein; carotid-vertebral 30-Sep-08 1
35509 Bypass graft, with vein; carotid-contralateral carotid 30-Sep-08 1
35510 Bypass graft, with vein; carotid-brachial 30-Sep-08 1
35511 Bypass graft, with vein; subclavian-subclavian 30-Sep-08 1
35512 Bypass graft, with vein; subclavian-brachial 30-Sep-08 1
35515 Bypass graft, with vein; subclavian-vertebral 30-Sep-08 1
35516 Bypass graft, with vein; subclavian-axillary 30-Sep-08 1
35518 Bypass graft, with vein; axillary-axillary 30-Sep-08 1
35521 Bypass graft, with vein; axillary-femoral 30-Sep-08 2
35522 Bypass graft, with vein; axillary-brachial 30-Sep-08 1
35523 Bypass graft, with vein; brachial-ulnar or -radial 30-Sep-08 2
35525 Bypass graft, with vein; brachial-brachial 30-Sep-08 1
35526 Bypass graft, with vein; aortosubclavian, aortoinnominate, or aortocarotid 30-Sep-08 3
35531 Bypass graft, with vein; aortoceliac or aortomesenteric 30-Sep-08 2

35533 Bypass graft, with vein; axillary-femoral-femoral 30-Sep-08 1
35535 Bypass graft, with vein; hepatorenal 15-Oct-12
35536 Bypass graft, with vein; splenorenal 30-Sep-08 1
35537 Bypass graft, with vein; aortoiliac 30-Sep-08 1
35538 Bypass graft, with vein; aortobi-iliac 30-Sep-08 1
35539 Bypass graft, with vein; aortofemoral 30-Sep-08 1
35540 Bypass graft, with vein; aortobifemoral 30-Sep-08 1
35548 Bypass graft, with vein; aortoiliofemoral, unilateral 30-Sep-08 1
35549 Bypass graft, with vein; aortoiliofemoral, bilateral 30-Sep-08 1
35551 Bypass graft, with vein; aortofemoral-popliteal 30-Sep-08 1
35556 Bypass graft, with vein; femoral-popliteal 30-Sep-08 2
35558 Bypass graft, with vein; femoral-femoral 30-Sep-08 2
35560 Bypass graft, with vein; aortorenal 30-Sep-08 2
35563 Bypass graft, with vein; ilioiliac 30-Sep-08 2
35565 Bypass graft, with vein; iliofemoral 30-Sep-08 2
35566 Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal artery or 30-Sep-08 2
other distal vessels
35570 Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal trunk-tibial 15-Oct-12
35571 Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal vessels 30-Sep-08 2
35572 Harvest of femoropopliteal vein, 1 segment, for vascular reconstruction 30-Sep-08 2

procedure (eg, aortic, vena caval, coronary, peripheral artery) (List separately in
35583 In-situ vein bypass; femoral-popliteal 30-Sep-08 2
35585 In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal artery 30-Sep-08 2
35587 In-situ vein bypass; popliteal-tibial, peroneal 30-Sep-08 2

35600 Harvest of upper extremity artery, 1 segment, for coronary artery bypass 30-Sep-08 2
procedure (List separately in addition to code for primary procedure)
35601 Bypass graft, with other than vein; common carotid-ipsilateral internal carotid 30-Sep-08 2
35606 Bypass graft, with other than vein; carotid-subclavian 30-Sep-08 1

35612 Bypass graft, with other than vein; subclavian-subclavian 30-Sep-08 1
35616 Bypass graft, with other than vein; subclavian-axillary 30-Sep-08 1
35621 Bypass graft, with other than vein; axillary-femoral 30-Sep-08 2
35623 Bypass graft, with other than vein; axillary-popliteal or -tibial 30-Sep-08 2
35626 Bypass graft, with other than vein; aortosubclavian, aortoinnominate, or 30-Sep-08 3
aortocarotid
35631 Bypass graft, with other than vein; aortoceliac, aortomesenteric, aortorenal 30-Sep-08
35632 Bypass graft, with other than vein; ilio-celiac 15-Oct-12

35633 Bypass graft, with other than vein; ilio-mesenteric 15-Oct-12
35634 Bypass graft, with other than vein; iliorenal 15-Oct-12
35636 Bypass graft, with other than vein; splenorenal (splenic to renal arterial 30-Sep-08 1
anastomosis)
35637 Bypass graft, with other than vein; aortoiliac 30-Sep-08 1
35638 Bypass graft, with other than vein; aortobi-iliac 30-Sep-08 1
35642 Bypass graft, with other than vein; carotid-vertebral 30-Sep-08 1
35645 Bypass graft, with other than vein; subclavian-vertebral 30-Sep-08 1
35646 Bypass graft, with other than vein; aortobifemoral 30-Sep-08 1
35647 Bypass graft, with other than vein; aortofemoral 30-Sep-08 1
35650 Bypass graft, with other than vein; axillary-axillary 30-Sep-08 1
35651 Bypass graft, with other than vein; aortofemoral-popliteal 30-Sep-08 2
35654 Bypass graft, with other than vein; axillary-femoral-femoral 30-Sep-08 1
35656 Bypass graft, with other than vein; femoral-popliteal 30-Sep-08 2
35661 Bypass graft, with other than vein; femoral-femoral 30-Sep-08 1
35663 Bypass graft, with other than vein; ilioiliac 30-Sep-08 2
35665 Bypass graft, with other than vein; iliofemoral 30-Sep-08 2
35666 Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, or 30-Sep-08 2
peroneal artery
35671 Bypass graft, with other than vein; popliteal-tibial or -peroneal artery 30-Sep-08 2
35681 Bypass graft; composite, prosthetic and vein (List separately in addition to code 30-Sep-08 2
35682 Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List 30-Sep-08 1
35683 Bypass graft; autogenous composite, 3 or more segments of vein from 2 or more 30-Sep-08 1
locations (List separately in addition to code for primary procedure)
35685 Placement of vein patch or cuff at distal anastomosis of bypass graft, synthetic 30-Sep-08 2
conduit (List separately in addition to code for primary procedure)
35686 Creation of distal arteriovenous fistula during lower extremity bypass surgery 30-Sep-08 1
(non-hemodialysis) (List separately in addition to code for primary procedure)
35691 Transposition and/or reimplantation; vertebral to carotid artery 30-Sep-08 2

35693 Transposition and/or reimplantation; vertebral to subclavian artery 30-Sep-08 2
35694 Transposition and/or reimplantation; subclavian to carotid artery 30-Sep-08 2
35695 Transposition and/or reimplantation; carotid to subclavian artery 30-Sep-08 2
35697 Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery (List 30-Sep-08 2
35700 Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior 30-Sep-08 2
tibial, peroneal artery, or other distal vessels, more than 1 month after original
operation (List separately in addition to code for primary procedure)
35701 Exploration (not followed by surgical repair), with or without lysis of artery; 30-Sep-08 2
carotid artery
femoral artery
popliteal artery
35761 Exploration (not followed by surgical repair), with or without lysis of artery; other 30-Sep-08 2
vessels
35800 Exploration for postoperative hemorrhage, thrombosis or infection; neck 30-Sep-08 2
35820 Exploration for postoperative hemorrhage, thrombosis or infection; chest 30-Sep-08 2
35840 Exploration for postoperative hemorrhage, thrombosis or infection; abdomen 30-Sep-08 2
35860 Exploration for postoperative hemorrhage, thrombosis or infection; extremity 30-Sep-08 2
35870 Repair of graft-enteric fistula 30-Sep-08 1

35875 Thrombectomy of arterial or venous graft (other than hemodialysis graft or 30-Sep-08 2
fistula);
35876 Thrombectomy of arterial or venous graft (other than hemodialysis graft or 30-Sep-08 2
fistula); with revision of arterial or venous graft
35879 Revision, lower extremity arterial bypass, without thrombectomy, open; with 30-Sep-08 2
vein patch angioplasty
35881 Revision, lower extremity arterial bypass, without thrombectomy, open; with 30-Sep-08 2
segmental vein interposition
35883 Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; 30-Sep-08 1
with nonautogenous patch graft (eg, Dacron, ePTFE, bovine pericardium)
35884 Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; 30-Sep-08 1
with autogenous vein patch graft
35901 Excision of infected graft; neck 30-Sep-08 1
35903 Excision of infected graft; extremity 30-Sep-08 2
35905 Excision of infected graft; thorax 30-Sep-08 1
35907 Excision of infected graft; abdomen 30-Sep-08 1
36000 Introduction of needle or intracatheter, vein 30-Sep-08
36002 Injection procedures (eg, thrombin) for percutaneous treatment of extremity 30-Sep-08 2
pseudoaneurysm
36005 Injection procedure for extremity venography (including introduction of needle or 30-Sep-08 2
intracatheter)
36010 Introduction of catheter, superior or inferior vena cava 30-Sep-08 2
36011 Selective catheter placement, venous system; first order branch (eg, renal vein, 30-Sep-08
jugular vein)
36012 Selective catheter placement, venous system; second order, or more selective, 30-Sep-08
branch (eg, left adrenal vein, petrosal sinus)
36013 Introduction of catheter, right heart or main pulmonary artery 30-Sep-08 2
36014 Selective catheter placement, left or right pulmonary artery 30-Sep-08 2
36015 Selective catheter placement, segmental or subsegmental pulmonary artery 30-Sep-08
36100 Introduction of needle or intracatheter, carotid or vertebral artery 30-Sep-08 2

36120 Introduction of needle or intracatheter; retrograde brachial artery 30-Sep-08 2
36140 Introduction of needle or intracatheter; extremity artery 30-Sep-08
36145 Introduction of needle or intracatheter; arteriovenous shunt created for dialysis 30-Sep-08 14-Oct-12
(cannula, fistula, or graft)
36147 Introduction of needle and/or catheter, arteriovenous shunt created for dialysis 15-Oct-12
(graft/fistula); initial access with complete radiological evaluation of dialysis
access, including fluoroscopy, image documentation and report (includes access
of shunt, injection[s] of contrast, and all necessary imaging from the arterial
anastomosis and adjacent artery through entire venous outflow including the
inferior or superior vena cava)
36148 Introduction of needle and/or catheter, arteriovenous shunt created for dialysis 15-Oct-12
(graft/fistula); additional access for therapeutic intervention (List separately in
36160 Introduction of needle or intracatheter, aortic, translumbar 30-Sep-08 2

36200 Introduction of catheter, aorta 30-Sep-08 2
36215 Selective catheter placement, arterial system; each first order thoracic or 30-Sep-08
brachiocephalic branch, within a vascular family
36216 Selective catheter placement, arterial system; initial second order thoracic or 30-Sep-08
brachiocephalic branch, within a vascular family
36217 Selective catheter placement, arterial system; initial third order or more 30-Sep-08
selective thoracic or brachiocephalic branch, within a vascular family
36218 Selective catheter placement, arterial system; additional second order, third 30-Sep-08
order, and beyond, thoracic or brachiocephalic branch, within a vascular family
(List in addition to code for initial second or third order vessel as appropriate)
36245 Selective catheter placement, arterial system; each first order abdominal, pelvic, 30-Sep-08
or lower extremity artery branch, within a vascular family
36246 Selective catheter placement, arterial system; initial second order abdominal, 30-Sep-08
pelvic, or lower extremity artery branch, within a vascular family
36247 Selective catheter placement, arterial system; initial third order or more 30-Sep-08
selective abdominal, pelvic, or lower extremity artery branch, within a vascular
family
36248 Selective catheter placement, arterial system; additional second order, third 30-Sep-08
order, and beyond, abdominal, pelvic, or lower extremity artery branch, within a
vascular family (List in addition to code for initial second or third order vessel as
appropriate)
36260 Insertion of implantable intra-arterial infusion pump (eg, for chemotherapy of 30-Sep-08 1
liver)
36261 Revision of implanted intra-arterial infusion pump 30-Sep-08 1
36262 Removal of implanted intra-arterial infusion pump 30-Sep-08 1
36299 Unlisted procedure, vascular injection 30-Sep-08
36400 Venipuncture, younger than age 3 years, necessitating physician's skill, not to be 30-Sep-08 1
used for routine venipuncture; femoral or jugular vein
used for routine venipuncture; scalp vein
used for routine venipuncture; other vein
36410 Venipuncture, age 3 years or older, necessitating physician's skill (separate 30-Sep-08 3
procedure), for diagnostic or therapeutic purposes (not to be used for routine
venipuncture)
36415 Collection of venous blood by venipuncture 30-Sep-08
36416 Collection of capillary blood specimen (eg, finger, heel, ear stick) 30-Sep-08
36420 Venipuncture, cutdown; younger than age 1 year 30-Sep-08 2
36425 Venipuncture, cutdown; age 1 or over 30-Sep-08 1
36430 Transfusion, blood or blood components 30-Sep-08 1
36440 Push transfusion, blood, 2 years or younger 30-Sep-08 1
36450 Exchange transfusion, blood; newborn 30-Sep-08 1
36455 Exchange transfusion, blood; other than newborn 30-Sep-08 1
36460 Transfusion, intrauterine, fetal 30-Sep-08
36468 Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); 30-Sep-08 1
limb or trunk
36469 Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); 30-Sep-08 1
face
36470 Injection of sclerosing solution; single vein 30-Sep-08 2
36471 Injection of sclerosing solution; multiple veins, same leg 30-Sep-08 2
36475 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all 30-Sep-08 2
imaging guidance and monitoring, percutaneous, radiofrequency; first vein
treated
36476 Endovenous ablation therapy of incompetent vein, extremity, inclusive of all 30-Sep-08
imaging guidance and monitoring, percutaneous, radiofrequency; second and
subsequent veins treated in a single extremity, each through separate access
sites (List separately in addition to code for primary procedure)
imaging guidance and monitoring, percutaneous, laser; first vein treated
imaging guidance and monitoring, percutaneous, laser; second and subsequent
veins treated in a single extremity, each through separate access sites (List
36481 Percutaneous portal vein catheterization by any method 30-Sep-08 1

36500 Venous catheterization for selective organ blood sampling 30-Sep-08
36510 Catheterization of umbilical vein for diagnosis or therapy, newborn 30-Sep-08 1
36511 Therapeutic apheresis; for white blood cells 30-Sep-08 1
36512 Therapeutic apheresis; for red blood cells 30-Sep-08 1
36513 Therapeutic apheresis; for platelets 30-Sep-08 1
36514 Therapeutic apheresis; for plasma pheresis 30-Sep-08 1
36515 Therapeutic apheresis; with extracorporeal immunoadsorption and plasma 30-Sep-08 1
reinfusion
36516 Therapeutic apheresis; with extracorporeal selective adsorption or selective 30-Sep-08 1
filtration and plasma reinfusion
36522 Photopheresis, extracorporeal 30-Sep-08 1
36555 Insertion of non-tunneled centrally inserted central venous catheter; younger 30-Sep-08 2
than 5 years of age
36556 Insertion of non-tunneled centrally inserted central venous catheter; age 5 years 30-Sep-08 2
or older
36557 Insertion of tunneled centrally inserted central venous catheter, without 30-Sep-08 2
subcutaneous port or pump; younger than 5 years of age
36558 Insertion of tunneled centrally inserted central venous catheter, without 30-Sep-08 2
subcutaneous port or pump; age 5 years or older
36560 Insertion of tunneled centrally inserted central venous access device, with 30-Sep-08 2
subcutaneous port; younger than 5 years of age
36561 Insertion of tunneled centrally inserted central venous access device, with 30-Sep-08 2
subcutaneous port; age 5 years or older
36563 Insertion of tunneled centrally inserted central venous access device with 30-Sep-08 2
subcutaneous pump
36565 Insertion of tunneled centrally inserted central venous access device, requiring 2 30-Sep-08 2
catheters via 2 separate venous access sites; without subcutaneous port or
pump (eg, Tesio type catheter)
36566 Insertion of tunneled centrally inserted central venous access device, requiring 2 30-Sep-08 2
catheters via 2 separate venous access sites; with subcutaneous port(s)
36568 Insertion of peripherally inserted central venous catheter (PICC), without 30-Sep-08 2
subcutaneous port or pump; younger than 5 years of age
36569 Insertion of peripherally inserted central venous catheter (PICC), without 30-Sep-08 2
subcutaneous port or pump; age 5 years or older
36570 Insertion of peripherally inserted central venous access device, with 30-Sep-08 2
subcutaneous port; younger than 5 years of age
36571 Insertion of peripherally inserted central venous access device, with 30-Sep-08 2
subcutaneous port; age 5 years or older
36575 Repair of tunneled or non-tunneled central venous access catheter, without 30-Sep-08 2
subcutaneous port or pump, central or peripheral insertion site
36576 Repair of central venous access device, with subcutaneous port or pump, central 30-Sep-08 2
or peripheral insertion site
36578 Replacement, catheter only, of central venous access device, with subcutaneous 30-Sep-08 2
port or pump, central or peripheral insertion site
36580 Replacement, complete, of a non-tunneled centrally inserted central venous 30-Sep-08 2
catheter, without subcutaneous port or pump, through same venous access
36581 Replacement, complete, of a tunneled centrally inserted central venous 30-Sep-08 2

catheter, without subcutaneous port or pump, through same venous access
36582 Replacement, complete, of a tunneled centrally inserted central venous access 30-Sep-08 2
device, with subcutaneous port, through same venous access
36583 Replacement, complete, of a tunneled centrally inserted central venous access 30-Sep-08 2
device, with subcutaneous pump, through same venous access
36584 Replacement, complete, of a peripherally inserted central venous catheter 30-Sep-08 2

(PICC), without subcutaneous port or pump, through same venous access
36585 Replacement, complete, of a peripherally inserted central venous access device, 30-Sep-08 2
with subcutaneous port, through same venous access
36589 Removal of tunneled central venous catheter, without subcutaneous port or 30-Sep-08 2
pump
36590 Removal of tunneled central venous access device, with subcutaneous port or 30-Sep-08 2
pump, central or peripheral insertion
36591 Collection of blood specimen from a completely implantable venous access 30-Sep-08
device
36592 Collection of blood specimen using established central or peripheral catheter, 30-Sep-08 1
venous, not otherwise specified
36593 Declotting by thrombolytic agent of implanted vascular access device or catheter 30-Sep-08 2
36595 Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from 30-Sep-08 2
central venous device via separate venous access
36596 Mechanical removal of intraluminal (intracatheter) obstructive material from 30-Sep-08 2
central venous device through device lumen
36597 Repositioning of previously placed central venous catheter under fluoroscopic 30-Sep-08 2
guidance
36598 Contrast injection(s) for radiologic evaluation of existing central venous access 30-Sep-08 2
device, including fluoroscopy, image documentation and report
36600 Arterial puncture, withdrawal of blood for diagnosis 30-Sep-08

36620 Arterial catheterization or cannulation for sampling, monitoring or transfusion 30-Sep-08 3
(separate procedure); percutaneous
36625 Arterial catheterization or cannulation for sampling, monitoring or transfusion 30-Sep-08 2
(separate procedure); cutdown
36640 Arterial catheterization for prolonged infusion therapy (chemotherapy), cutdown 30-Sep-08 1
36660 Catheterization, umbilical artery, newborn, for diagnosis or therapy 30-Sep-08 1

36680 Placement of needle for intraosseous infusion 30-Sep-08 1
36800 Insertion of cannula for hemodialysis, other purpose (separate procedure); vein 30-Sep-08 1
to vein
36810 Insertion of cannula for hemodialysis, other purpose (separate procedure); 30-Sep-08 1
arteriovenous, external (Scribner type)
36815 Insertion of cannula for hemodialysis, other purpose (separate procedure); 30-Sep-08 1
arteriovenous, external revision, or closure
36818 Arteriovenous anastomosis, open; by upper arm cephalic vein transposition 30-Sep-08 1
36819 Arteriovenous anastomosis, open; by upper arm basilic vein transposition 30-Sep-08 1
36820 Arteriovenous anastomosis, open; by forearm vein transposition 30-Sep-08 2

36821 Arteriovenous anastomosis, open; direct, any site (eg, Cimino type) (separate 30-Sep-08 2
procedure)
36822 Insertion of cannula(s) for prolonged extracorporeal circulation for 30-Sep-08 1
cardiopulmonary insufficiency (ECMO) (separate procedure)
36823 Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation 30-Sep-08 1
including regional chemotherapy perfusion to an extremity, with or without
hyperthermia, with removal of cannula(s) and repair of arteriotomy and
venotomy sites
36825 Creation of arteriovenous fistula by other than direct arteriovenous anastomosis 30-Sep-08 1
(separate procedure); autogenous graft
36830 Creation of arteriovenous fistula by other than direct arteriovenous anastomosis 30-Sep-08 2
(separate procedure); nonautogenous graft (eg, biological collagen,
thermoplastic graft)
36831 Thrombectomy, open, arteriovenous fistula without revision, autogenous or 30-Sep-08 1
nonautogenous dialysis graft (separate procedure)
36832 Revision, open, arteriovenous fistula; without thrombectomy, autogenous or 30-Sep-08 2
36833 Revision, open, arteriovenous fistula; with thrombectomy, autogenous or 30-Sep-08 1
36834 Plastic repair of arteriovenous aneurysm (separate procedure) 30-Sep-08 14-Oct-12
36835 Insertion of Thomas shunt (separate procedure) 30-Sep-08 1
36838 Distal revascularization and interval ligation (DRIL), upper extremity 30-Sep-08 2
hemodialysis access (steal syndrome)
36860 External cannula declotting (separate procedure); without balloon catheter 30-Sep-08 2
36861 External cannula declotting (separate procedure); with balloon catheter 30-Sep-08 2
36870 Thrombectomy, percutaneous, arteriovenous fistula, autogenous or 30-Sep-08 2

nonautogenous graft (includes mechanical thrombus extraction and intra-graft
thrombolysis)
37140 Venous anastomosis, open; portocaval 30-Sep-08 1
37145 Venous anastomosis, open; renoportal 30-Sep-08 1
37160 Venous anastomosis, open; caval-mesenteric 30-Sep-08 1
37180 Venous anastomosis, open; splenorenal, proximal 30-Sep-08 1
37181 Venous anastomosis, open; splenorenal, distal (selective decompression of 30-Sep-08 1
esophagogastric varices, any technique)
37182 Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes 30-Sep-08 1
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 30-Sep-08 1

venous access, hepatic and portal vein catheterization, portography with
hemodynamic evaluation, intrahepatic tract recanulization/dilatation, stent
placement and all associated imaging guidance and documentation)
37184 Primary percutaneous transluminal mechanical thrombectomy, noncoronary, 30-Sep-08 2

arterial or arterial bypass graft, including fluoroscopic guidance and
intraprocedural pharmacological thrombolytic injection(s); initial vessel
37185 Primary percutaneous transluminal mechanical thrombectomy, noncoronary, 30-Sep-08 2

arterial or arterial bypass graft, including fluoroscopic guidance and
intraprocedural pharmacological thrombolytic injection(s); second and all
subsequent vessel(s) within the same vascular family (List separately in addition
to code for primary mechanical thrombectomy procedure)
37186 Secondary percutaneous transluminal thrombectomy (eg, nonprimary 30-Sep-08 2

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 mechanical thrombectomy (List
37187 Percutaneous transluminal mechanical thrombectomy, vein(s), including 30-Sep-08 2

intraprocedural pharmacological thrombolytic injections and fluoroscopic
guidance
37188 Percutaneous transluminal mechanical thrombectomy, vein(s), including 30-Sep-08 2
intraprocedural pharmacological thrombolytic injections and fluoroscopic
guidance, repeat treatment on subsequent day during course of thrombolytic
therapy
37195 Thrombolysis, cerebral, by intravenous infusion 30-Sep-08 1
37200 Transcatheter biopsy 30-Sep-08 2
37201 Transcatheter therapy, infusion for thrombolysis other than coronary 30-Sep-08 1
37202 Transcatheter therapy, infusion other than for thrombolysis, any type (eg, 30-Sep-08
spasmolytic, vasoconstrictive)
37203 Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, 30-Sep-08 2
fractured venous or arterial catheter)
37204 Transcatheter occlusion or embolization (eg, for tumor destruction, to achieve 30-Sep-08
hemostasis, to occlude a vascular malformation), percutaneous, any method,
non-central nervous system, non-head or neck
37205 Transcatheter placement of an intravascular stent(s) (except coronary, carotid, 30-Sep-08 1

vertebral, iliac, and lower extremity arteries), percutaneous; initial vessel
37206 Transcatheter placement of an intravascular stent(s) (except coronary, carotid, 30-Sep-08

vertebral, iliac, and lower extremity arteries), percutaneous; each additional
vessel (List separately in addition to code for primary procedure)
37207 Transcatheter placement of an intravascular stent(s) (except coronary, carotid, 30-Sep-08 1

vertebral, iliac and lower extremity arteries), open; initial vessel
37208 Transcatheter placement of an intravascular stent(s) (except coronary, carotid, 30-Sep-08

vertebral, iliac and lower extremity arteries), open; each additional vessel (List
37209 Exchange of a previously placed intravascular catheter during thrombolytic 30-Sep-08 2

therapy
37210 Uterine fibroid embolization (UFE, embolization of the uterine arteries to treat 30-Sep-08 1
uterine fibroids, leiomyomata), percutaneous approach inclusive of vascular
access, vessel selection, embolization, and all radiological supervision and
interpretation, intraprocedural roadmapping, and imaging guidance necessary to
complete the procedure
37215 Transcatheter placement of intravascular stent(s), cervical carotid artery, 30-Sep-08 2

percutaneous; with distal embolic protection
37216 Transcatheter placement of intravascular stent(s), cervical carotid artery, 30-Sep-08
percutaneous; without distal embolic protection
37220 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, 15-Oct-12 1
initial vessel; with transluminal angioplasty
37221 Revascularization, endovascular, open or percutaneous, iliac artery, unilateral, 15-Oct-12 1
initial vessel; with transluminal stent placement(s), includes angioplasty within
the same vessel, when performed
37222 Revascularization, endovascular, open or percutaneous, iliac artery, each 15-Oct-12 2
additional ipsilateral iliac vessel; with transluminal angioplasty (List separately in
37223 Revascularization, endovascular, open or percutaneous, iliac artery, each 15-Oct-12 2
additional ipsilateral iliac vessel; with transluminal stent placement(s), includes
angioplasty within the same vessel, when performed (List separately in addition
37224 Revascularization, endovascular, open or percutaneous, femoral, popliteal 15-Oct-12 1
artery(s), unilateral; with transluminal angioplasty
artery(s), unilateral; with atherectomy, includes angioplasty within the same
vessel, when performed
artery(s), unilateral; with transluminal stent placement(s), includes angioplasty
within the same vessel, when performed
artery(s), unilateral; with transluminal stent placement(s) and atherectomy,
includes angioplasty within the same vessel, when performed
37228 Revascularization, endovascular, open or percutaneous, tibial, peroneal artery, 15-Oct-12 1

unilateral, initial vessel; with transluminal angioplasty
unilateral, initial vessel; with atherectomy, includes angioplasty within the same
vessel, when performed
unilateral, initial vessel; with transluminal stent placement(s), includes
angioplasty within the same vessel, when performed

unilateral, initial vessel; with transluminal stent placement(s) and atherectomy,
includes angioplasty within the same vessel, when performed
37232 Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, 15-Oct-12 2

unilateral, each additional vessel; with transluminal angioplasty (List separately

unilateral, each additional vessel; with atherectomy, includes angioplasty within
the same vessel, when performed (List separately in addition to code for primary
procedure)
unilateral, each additional vessel; with transluminal stent placement(s), includes
angioplasty within the same vessel, when performed (List separately in addition

unilateral, each additional vessel; with transluminal stent placement(s) and
atherectomy, includes angioplasty within the same vessel, when performed (List
37250 Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation 30-Sep-08 1

and/or therapeutic intervention; initial vessel (List separately in addition to code
37251 Intravascular ultrasound (non-coronary vessel) during diagnostic evaluation 30-Sep-08
and/or therapeutic intervention; each additional vessel (List separately in
37500 Vascular endoscopy, surgical, with ligation of perforator veins, subfascial (SEPS) 30-Sep-08 2
37501 Unlisted vascular endoscopy procedure 30-Sep-08
37565 Ligation, internal jugular vein 30-Sep-08 2

37600 Ligation; external carotid artery 30-Sep-08 1
37605 Ligation; internal or common carotid artery 30-Sep-08 2
37606 Ligation; internal or common carotid artery, with gradual occlusion, as with 30-Sep-08 2
Selverstone or Crutchfield clamp
37607 Ligation or banding of angioaccess arteriovenous fistula 30-Sep-08 1
37609 Ligation or biopsy, temporal artery 30-Sep-08 2
37615 Ligation, major artery (eg, post-traumatic, rupture); neck 30-Sep-08 2
37616 Ligation, major artery (eg, post-traumatic, rupture); chest 30-Sep-08 1
37617 Ligation, major artery (eg, post-traumatic, rupture); abdomen 30-Sep-08 3
37618 Ligation, major artery (eg, post-traumatic, rupture); extremity 30-Sep-08 2
37620 Interruption, partial or complete, of inferior vena cava by suture, ligation, 30-Sep-08 1
plication, clip, extravascular, intravascular (umbrella device)
37650 Ligation of femoral vein 30-Sep-08 1
37660 Ligation of common iliac vein 30-Sep-08 2
37700 Ligation and division of long saphenous vein at saphenofemoral junction, or 30-Sep-08 1
distal interruptions
37718 Ligation, division, and stripping, short saphenous vein 30-Sep-08 1
37722 Ligation, division, and stripping, long (greater) saphenous veins from 30-Sep-08 1
saphenofemoral junction to knee or below
37735 Ligation and division and complete stripping of long or short saphenous veins 30-Sep-08 1
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, 30-Sep-08 1
when performed, open,1 leg
37761 Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, 15-Oct-12
when performed, 1 leg
37765 Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions 30-Sep-08 2
37766 Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions 30-Sep-08 2
37780 Ligation and division of short saphenous vein at saphenopopliteal junction 30-Sep-08 1
37785 Ligation, division, and/or excision of varicose vein cluster(s), 1 leg 30-Sep-08 1
37788 Penile revascularization, artery, with or without vein graft 30-Sep-08 1

37790 Penile venous occlusive procedure 30-Sep-08 1
37799 Unlisted procedure, vascular surgery 30-Sep-08
38100 Splenectomy; total (separate procedure) 30-Sep-08 1

38101 Splenectomy; partial (separate procedure) 30-Sep-08 1
38102 Splenectomy; total, en bloc for extensive disease, in conjunction with other 30-Sep-08 1
procedure (List in addition to code for primary procedure)
38115 Repair of ruptured spleen (splenorrhaphy) with or without partial splenectomy 30-Sep-08 1
38120 Laparoscopy, surgical, splenectomy 30-Sep-08 1

38129 Unlisted laparoscopy procedure, spleen 30-Sep-08
38200 Injection procedure for splenoportography 30-Sep-08 1

38204 Management of recipient hematopoietic progenitor cell donor search and cell 30-Sep-08
acquisition
38205 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per 30-Sep-08 1
collection; allogenic
38206 Blood-derived hematopoietic progenitor cell harvesting for transplantation, per 30-Sep-08 1
collection; autologous
38207 Transplant preparation of hematopoietic progenitor cells; cryopreservation and 30-Sep-08
storage
38208 Transplant preparation of hematopoietic progenitor cells; thawing of previously 30-Sep-08
frozen harvest, without washing
38209 Transplant preparation of hematopoietic progenitor cells; thawing of previously 30-Sep-08
frozen harvest, with washing
38210 Transplant preparation of hematopoietic progenitor cells; specific cell depletion 30-Sep-08
within harvest, T-cell depletion
38211 Transplant preparation of hematopoietic progenitor cells; tumor cell depletion 30-Sep-08
38212 Transplant preparation of hematopoietic progenitor cells; red blood cell removal 30-Sep-08
38213 Transplant preparation of hematopoietic progenitor cells; platelet depletion 30-Sep-08
38214 Transplant preparation of hematopoietic progenitor cells; plasma (volume) 30-Sep-08

depletion
38215 Transplant preparation of hematopoietic progenitor cells; cell concentration in 30-Sep-08
plasma, mononuclear, or buffy coat layer
38220 Bone marrow; aspiration only 30-Sep-08 2
38221 Bone marrow; biopsy, needle or trocar 30-Sep-08 2
38230 Bone marrow harvesting for transplantation 30-Sep-08 1
38240 Bone marrow or blood-derived peripheral stem cell transplantation; allogenic 30-Sep-08 1
38241 Bone marrow or blood-derived peripheral stem cell transplantation; autologous 30-Sep-08 1
38242 Bone marrow or blood-derived peripheral stem cell transplantation; allogeneic 30-Sep-08 1
donor lymphocyte infusions
38300 Drainage of lymph node abscess or lymphadenitis; simple 30-Sep-08 2
38305 Drainage of lymph node abscess or lymphadenitis; extensive 30-Sep-08 2
38308 Lymphangiotomy or other operations on lymphatic channels 30-Sep-08 1
38380 Suture and/or ligation of thoracic duct; cervical approach 30-Sep-08 1
38381 Suture and/or ligation of thoracic duct; thoracic approach 30-Sep-08 1
38382 Suture and/or ligation of thoracic duct; abdominal approach 30-Sep-08 1
38500 Biopsy or excision of lymph node(s); open, superficial 30-Sep-08 2
38505 Biopsy or excision of lymph node(s); by needle, superficial (eg, cervical, inguinal, 30-Sep-08 3
axillary)
38510 Biopsy or excision of lymph node(s); open, deep cervical node(s) 30-Sep-08 2
38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision 30-Sep-08 2
scalene fat pad
38525 Biopsy or excision of lymph node(s); open, deep axillary node(s) 30-Sep-08 2
38530 Biopsy or excision of lymph node(s); open, internal mammary node(s) 30-Sep-08 2
38542 Dissection, deep jugular node(s) 30-Sep-08 2
38550 Excision of cystic hygroma, axillary or cervical; without deep neurovascular 30-Sep-08 1
dissection
38555 Excision of cystic hygroma, axillary or cervical; with deep neurovascular 30-Sep-08 1
dissection
38562 Limited lymphadenectomy for staging (separate procedure); pelvic and para- 30-Sep-08 1
aortic
38564 Limited lymphadenectomy for staging (separate procedure); retroperitoneal 30-Sep-08 1
(aortic and/or splenic)
38570 Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single 30-Sep-08 1
or multiple
38571 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy 30-Sep-08 1
38572 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri- 30-Sep-08 1
aortic lymph node sampling (biopsy), single or multiple
38589 Unlisted laparoscopy procedure, lymphatic system 30-Sep-08
38700 Suprahyoid lymphadenectomy 30-Sep-08 1

38720 Cervical lymphadenectomy (complete) 30-Sep-08 1
38724 Cervical lymphadenectomy (modified radical neck dissection) 30-Sep-08 2
38740 Axillary lymphadenectomy; superficial 30-Sep-08 2
38745 Axillary lymphadenectomy; complete 30-Sep-08 2
38746 Thoracic lymphadenectomy, regional, including mediastinal and peritracheal 30-Sep-08 1
nodes (List separately in addition to code for primary procedure)
38747 Abdominal lymphadenectomy, regional, including celiac, gastric, portal, 30-Sep-08 1

peripancreatic, with or without para-aortic and vena caval nodes (List separately
38760 Inguinofemoral lymphadenectomy, superficial, including Cloquets node 30-Sep-08 1
38765 Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic 30-Sep-08 1
lymphadenectomy, including external iliac, hypogastric, and obturator nodes
38770 Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator 30-Sep-08 1
nodes (separate procedure)
38780 Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, 30-Sep-08 1
aortic, and renal nodes (separate procedure)
38790 Injection procedure; lymphangiography 30-Sep-08 1
38792 Injection procedure; for identification of sentinel node 30-Sep-08 2
38794 Cannulation, thoracic duct 30-Sep-08 1
38900 Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes 15-Oct-12 2
injection of non-radioactive dye, when performed (List separately in addition to
38999 Unlisted procedure, hemic or lymphatic system 30-Sep-08
39000 Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; 30-Sep-08 1
cervical approach
39010 Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; 30-Sep-08 1
transthoracic approach, including either transthoracic or median sternotomy
39200 Excision of mediastinal cyst 30-Sep-08 1

39220 Excision of mediastinal tumor 30-Sep-08 1
39400 Mediastinoscopy, with or without biopsy 30-Sep-08 1
39499 Unlisted procedure, mediastinum 30-Sep-08
39501 Repair, laceration of diaphragm, any approach 30-Sep-08 1

39502 Repair, paraesophageal hiatus hernia, transabdominal, with or without 30-Sep-08 14-Oct-12
fundoplasty, vagotomy, and/or pyloroplasty, except neonatal
39503 Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and 30-Sep-08 1
with or without creation of ventral hernia
39520 Repair, diaphragmatic hernia (esophageal hiatal); transthoracic 30-Sep-08 14-Oct-12
39530 Repair, diaphragmatic hernia (esophageal hiatal); combined, thoracoabdominal 30-Sep-08 14-Oct-12
39531 Repair, diaphragmatic hernia (esophageal hiatal); combined, thoracoabdominal, 30-Sep-08 14-Oct-12
with dilation of stricture (with or without gastroplasty)
39540 Repair, diaphragmatic hernia (other than neonatal), traumatic; acute 30-Sep-08 1
39541 Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic 30-Sep-08 1
39545 Imbrication of diaphragm for eventration, transthoracic or transabdominal, 30-Sep-08 1

paralytic or nonparalytic
39560 Resection, diaphragm; with simple repair (eg, primary suture) 30-Sep-08 1
39561 Resection, diaphragm; with complex repair (eg, prosthetic material, local muscle 30-Sep-08 1
flap)
39599 Unlisted procedure, diaphragm 30-Sep-08
40490 Biopsy of lip 30-Sep-08

40500 Vermilionectomy (lip shave), with mucosal advancement 30-Sep-08 2
40510 Excision of lip; transverse wedge excision with primary closure 30-Sep-08 2
40520 Excision of lip; V-excision with primary direct linear closure 30-Sep-08 2
40525 Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan) 30-Sep-08 2
40527 Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander) 30-Sep-08 2
40530 Resection of lip, more than one-fourth, without reconstruction 30-Sep-08 2
40650 Repair lip, full thickness; vermilion only 30-Sep-08 2
40652 Repair lip, full thickness; up to half vertical height 30-Sep-08 2
40654 Repair lip, full thickness; over one-half vertical height, or complex 30-Sep-08 2
40700 Plastic repair of cleft lip/nasal deformity; primary, partial or complete, unilateral 30-Sep-08 1
40701 Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure 30-Sep-08 1
40702 Plastic repair of cleft lip/nasal deformity; primary bilateral, 1 of 2 stages 30-Sep-08 1
40720 Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and 30-Sep-08 1
reclosure
40761 Plastic repair of cleft lip/nasal deformity; with cross lip pedicle flap (Abbe- 30-Sep-08 1
Estlander type), including sectioning and inserting of pedicle
40799 Unlisted procedure, lips 30-Sep-08
40800 Drainage of abscess, cyst, hematoma, vestibule of mouth; simple 30-Sep-08 1

40801 Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated 30-Sep-08 1
40804 Removal of embedded foreign body, vestibule of mouth; simple 30-Sep-08

40805 Removal of embedded foreign body, vestibule of mouth; complicated 30-Sep-08
40806 Incision of labial frenum (frenotomy) 30-Sep-08 2
40808 Biopsy, vestibule of mouth 30-Sep-08
40810 Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair 30-Sep-08
40812 Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple 30-Sep-08
repair
40814 Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex 30-Sep-08
repair
40816 Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with 30-Sep-08 2
excision of underlying muscle
40818 Excision of mucosa of vestibule of mouth as donor graft 30-Sep-08 2
40819 Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) 30-Sep-08 2
40820 Destruction of lesion or scar of vestibule of mouth by physical methods (eg, 30-Sep-08 2
laser, thermal, cryo, chemical)
40830 Closure of laceration, vestibule of mouth; 2.5 cm or less 30-Sep-08 2
40831 Closure of laceration, vestibule of mouth; over 2.5 cm or complex 30-Sep-08 2
40840 Vestibuloplasty; anterior 30-Sep-08 1
40842 Vestibuloplasty; posterior, unilateral 30-Sep-08 1
40843 Vestibuloplasty; posterior, bilateral 30-Sep-08 1
40844 Vestibuloplasty; entire arch 30-Sep-08 2
40845 Vestibuloplasty; complex (including ridge extension, muscle repositioning) 30-Sep-08 1
40899 Unlisted procedure, vestibule of mouth 30-Sep-08
41000 Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor 30-Sep-08 1
of mouth; lingual
of mouth; sublingual, superficial
of mouth; sublingual, deep, supramylohyoid
of mouth; submental space
of mouth; submandibular space
of mouth; masticator space
41010 Incision of lingual frenum (frenotomy) 30-Sep-08 1
41015 Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; 30-Sep-08 2
sublingual
submental
submandibular
masticator space
41019 Placement of needles, catheters, or other device(s) into the head and/or neck 30-Sep-08 1
region (percutaneous, transoral, or transnasal) for subsequent interstitial
radioelement application
41100 Biopsy of tongue; anterior two-thirds 30-Sep-08 3
41105 Biopsy of tongue; posterior one-third 30-Sep-08 3
41108 Biopsy of floor of mouth 30-Sep-08 2
41110 Excision of lesion of tongue without closure 30-Sep-08 2
41112 Excision of lesion of tongue with closure; anterior two-thirds 30-Sep-08 2
41113 Excision of lesion of tongue with closure; posterior one-third 30-Sep-08 2
41114 Excision of lesion of tongue with closure; with local tongue flap 30-Sep-08 2
41115 Excision of lingual frenum (frenectomy) 30-Sep-08 1
41116 Excision, lesion of floor of mouth 30-Sep-08 3
41120 Glossectomy; less than one-half tongue 30-Sep-08 1
41130 Glossectomy; hemiglossectomy 30-Sep-08 1
41135 Glossectomy; partial, with unilateral radical neck dissection 30-Sep-08 1
41140 Glossectomy; complete or total, with or without tracheostomy, without radical 30-Sep-08 1
neck dissection
41145 Glossectomy; complete or total, with or without tracheostomy, with unilateral 30-Sep-08 1
radical neck dissection
41150 Glossectomy; composite procedure with resection floor of mouth and mandibular 30-Sep-08 1
resection, without radical neck dissection
41153 Glossectomy; composite procedure with resection floor of mouth, with 30-Sep-08 1
suprahyoid neck dissection
41155 Glossectomy; composite procedure with resection floor of mouth, mandibular 30-Sep-08 1
resection, and radical neck dissection (Commando type)
41250 Repair of laceration 2.5 cm or less; floor of mouth and/or anterior two-thirds of 30-Sep-08 2
tongue
41251 Repair of laceration 2.5 cm or less; posterior one-third of tongue 30-Sep-08 2
41252 Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex 30-Sep-08 2
41500 Fixation of tongue, mechanical, other than suture (eg, K-wire) 30-Sep-08 1
41510 Suture of tongue to lip for micrognathia (Douglas type procedure) 30-Sep-08 1
41512 Tongue base suspension, permanent suture technique 15-Oct-12 1
41520 Frenoplasty (surgical revision of frenum, eg, with Z-plasty) 30-Sep-08 1
41530 Submucosal ablation of the tongue base, radiofrequency, 1 or more sites, per 15-Oct-12
session
41599 Unlisted procedure, tongue, floor of mouth 30-Sep-08
41800 Drainage of abscess, cyst, hematoma from dentoalveolar structures 30-Sep-08 2

41805 Removal of embedded foreign body from dentoalveolar structures; soft tissues 30-Sep-08
41806 Removal of embedded foreign body from dentoalveolar structures; bone 30-Sep-08
41820 Gingivectomy, excision gingiva, each quadrant 30-Sep-08 4

41821 Operculectomy, excision pericoronal tissues 30-Sep-08
41822 Excision of fibrous tuberosities, dentoalveolar structures 30-Sep-08 1

41823 Excision of osseous tuberosities, dentoalveolar structures 30-Sep-08 1
41825 Excision of lesion or tumor (except listed above), dentoalveolar structures; 30-Sep-08 2
without repair
41826 Excision of lesion or tumor (except listed above), dentoalveolar structures; with 30-Sep-08 2
simple repair
41827 Excision of lesion or tumor (except listed above), dentoalveolar structures; with 30-Sep-08 2
complex repair
41828 Excision of hyperplastic alveolar mucosa, each quadrant (specify) 30-Sep-08 4
41830 Alveolectomy, including curettage of osteitis or sequestrectomy 30-Sep-08
41850 Destruction of lesion (except excision), dentoalveolar structures 30-Sep-08 2
41870 Periodontal mucosal grafting 30-Sep-08
41872 Gingivoplasty, each quadrant (specify) 30-Sep-08 4

41874 Alveoloplasty, each quadrant (specify) 30-Sep-08 4
41899 Unlisted procedure, dentoalveolar structures 30-Sep-08
42000 Drainage of abscess of palate, uvula 30-Sep-08 1

42100 Biopsy of palate, uvula 30-Sep-08 3
42104 Excision, lesion of palate, uvula; without closure 30-Sep-08 3
42106 Excision, lesion of palate, uvula; with simple primary closure 30-Sep-08 2
42107 Excision, lesion of palate, uvula; with local flap closure 30-Sep-08 2
42120 Resection of palate or extensive resection of lesion 30-Sep-08 1
42140 Uvulectomy, excision of uvula 30-Sep-08 1
42145 Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty) 30-Sep-08 1
42160 Destruction of lesion, palate or uvula (thermal, cryo or chemical) 30-Sep-08 1

42180 Repair, laceration of palate; up to 2 cm 30-Sep-08 1
42182 Repair, laceration of palate; over 2 cm or complex 30-Sep-08 1
42200 Palatoplasty for cleft palate, soft and/or hard palate only 30-Sep-08 1
42205 Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only 30-Sep-08 1
42210 Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to 30-Sep-08 1
alveolar ridge (includes obtaining graft)
42215 Palatoplasty for cleft palate; major revision 30-Sep-08 1
42220 Palatoplasty for cleft palate; secondary lengthening procedure 30-Sep-08 1
42225 Palatoplasty for cleft palate; attachment pharyngeal flap 30-Sep-08 1
42226 Lengthening of palate, and pharyngeal flap 30-Sep-08 1
42227 Lengthening of palate, with island flap 30-Sep-08 1
42235 Repair of anterior palate, including vomer flap 30-Sep-08 1
42260 Repair of nasolabial fistula 30-Sep-08 1
42280 Maxillary impression for palatal prosthesis 30-Sep-08 1
42281 Insertion of pin-retained palatal prosthesis 30-Sep-08 1
42299 Unlisted procedure, palate, uvula 30-Sep-08
42300 Drainage of abscess; parotid, simple 30-Sep-08 2

42305 Drainage of abscess; parotid, complicated 30-Sep-08 2
42310 Drainage of abscess; submaxillary or sublingual, intraoral 30-Sep-08 2
42320 Drainage of abscess; submaxillary, external 30-Sep-08 2
42330 Sialolithotomy; submandibular (submaxillary), sublingual or parotid, 30-Sep-08 3
uncomplicated, intraoral
42335 Sialolithotomy; submandibular (submaxillary), complicated, intraoral 30-Sep-08 2
42340 Sialolithotomy; parotid, extraoral or complicated intraoral 30-Sep-08 2
42400 Biopsy of salivary gland; needle 30-Sep-08 2
42405 Biopsy of salivary gland; incisional 30-Sep-08 2
42408 Excision of sublingual salivary cyst (ranula) 30-Sep-08 1
42409 Marsupialization of sublingual salivary cyst (ranula) 30-Sep-08 1
42410 Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection 30-Sep-08 2
42415 Excision of parotid tumor or parotid gland; lateral lobe, with dissection and 30-Sep-08 2
preservation of facial nerve
42420 Excision of parotid tumor or parotid gland; total, with dissection and preservation 30-Sep-08 2
of facial nerve
42425 Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of 30-Sep-08 2
facial nerve
42426 Excision of parotid tumor or parotid gland; total, with unilateral radical neck 30-Sep-08 2
dissection
42440 Excision of submandibular (submaxillary) gland 30-Sep-08 2
42450 Excision of sublingual gland 30-Sep-08 1
42500 Plastic repair of salivary duct, sialodochoplasty; primary or simple 30-Sep-08 2
42505 Plastic repair of salivary duct, sialodochoplasty; secondary or complicated 30-Sep-08 1
42507 Parotid duct diversion, bilateral (Wilke type procedure); 30-Sep-08 1

42508 Parotid duct diversion, bilateral (Wilke type procedure); with excision of 1 30-Sep-08 1
submandibular gland
42509 Parotid duct diversion, bilateral (Wilke type procedure); with excision of both 30-Sep-08 1
submandibular glands
42510 Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both 30-Sep-08 1
submandibular (Wharton's) ducts
42550 Injection procedure for sialography 30-Sep-08 2
42600 Closure salivary fistula 30-Sep-08 1
42650 Dilation salivary duct 30-Sep-08 2
42660 Dilation and catheterization of salivary duct, with or without injection 30-Sep-08 2
42665 Ligation salivary duct, intraoral 30-Sep-08 2
42699 Unlisted procedure, salivary glands or ducts 30-Sep-08
42700 Incision and drainage abscess; peritonsillar 30-Sep-08 2

42720 Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral 30-Sep-08 1
approach
42725 Incision and drainage abscess; retropharyngeal or parapharyngeal, external 30-Sep-08 2
approach
42800 Biopsy; oropharynx 30-Sep-08 3
42802 Biopsy; hypopharynx 30-Sep-08 2
42804 Biopsy; nasopharynx, visible lesion, simple 30-Sep-08
42806 Biopsy; nasopharynx, survey for unknown primary lesion 30-Sep-08 1
42808 Excision or destruction of lesion of pharynx, any method 30-Sep-08 2
42809 Removal of foreign body from pharynx 30-Sep-08 1
42810 Excision branchial cleft cyst or vestige, confined to skin and subcutaneous 30-Sep-08 2
tissues
42815 Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous 30-Sep-08 2
tissues and/or into pharynx
42820 Tonsillectomy and adenoidectomy; younger than age 12 30-Sep-08 1
42821 Tonsillectomy and adenoidectomy; age 12 or over 30-Sep-08 1
42825 Tonsillectomy, primary or secondary; younger than age 12 30-Sep-08 1
42826 Tonsillectomy, primary or secondary; age 12 or over 30-Sep-08 1
42830 Adenoidectomy, primary; younger than age 12 30-Sep-08 1
42831 Adenoidectomy, primary; age 12 or over 30-Sep-08 1
42835 Adenoidectomy, secondary; younger than age 12 30-Sep-08 1
42836 Adenoidectomy, secondary; age 12 or over 30-Sep-08 1
42842 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without 30-Sep-08 1
closure
42844 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure 30-Sep-08 1
with local flap (eg, tongue, buccal)
42845 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure 30-Sep-08 1
with other flap
42860 Excision of tonsil tags 30-Sep-08 1
42870 Excision or destruction lingual tonsil, any method (separate procedure) 30-Sep-08 1
42890 Limited pharyngectomy 30-Sep-08 1

42892 Resection of lateral pharyngeal wall or pyriform sinus, direct closure by 30-Sep-08 1
advancement of lateral and posterior pharyngeal walls
42894 Resection of pharyngeal wall requiring closure with myocutaneous or 30-Sep-08 1
fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular
anastamosis
42900 Suture pharynx for wound or injury 30-Sep-08 1
42950 Pharyngoplasty (plastic or reconstructive operation on pharynx) 30-Sep-08 1
42953 Pharyngoesophageal repair 30-Sep-08 1
42955 Pharyngostomy (fistulization of pharynx, external for feeding) 30-Sep-08 1
42960 Control oropharyngeal hemorrhage, primary or secondary (eg, post- 30-Sep-08 1
tonsillectomy); simple
tonsillectomy); complicated, requiring hospitalization
tonsillectomy); with secondary surgical intervention
42970 Control of nasopharyngeal hemorrhage, primary or secondary (eg, 30-Sep-08 1
postadenoidectomy); simple, with posterior nasal packs, with or without anterior
packs and/or cautery
postadenoidectomy); complicated, requiring hospitalization
postadenoidectomy); with secondary surgical intervention
42999 Unlisted procedure, pharynx, adenoids, or tonsils 30-Sep-08
43020 Esophagotomy, cervical approach, with removal of foreign body 30-Sep-08 1

43030 Cricopharyngeal myotomy 30-Sep-08 1
43045 Esophagotomy, thoracic approach, with removal of foreign body 30-Sep-08 1
43100 Excision of lesion, esophagus, with primary repair; cervical approach 30-Sep-08 1
43101 Excision of lesion, esophagus, with primary repair; thoracic or abdominal 30-Sep-08 1
approach
43107 Total or near total esophagectomy, without thoracotomy; with 30-Sep-08 1
pharyngogastrostomy or cervical esophagogastrostomy, with or without
pyloroplasty (transhiatal)
43108 Total or near total esophagectomy, without thoracotomy; with colon interposition 30-Sep-08 1
or small intestine reconstruction, including intestine mobilization, preparation
and anastomosis(es)
43112 Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy 30-Sep-08 1
or cervical esophagogastrostomy, with or without pyloroplasty
43113 Total or near total esophagectomy, with thoracotomy; with colon interposition or 30-Sep-08 1
small intestine reconstruction, including intestine mobilization, preparation, and
anastomosis(es)
43116 Partial esophagectomy, cervical, with free intestinal graft, including 30-Sep-08 1
microvascular anastomosis, obtaining the graft and intestinal reconstruction
43117 Partial esophagectomy, distal two-thirds, with thoracotomy and separate 30-Sep-08 1
abdominal incision, with or without proximal gastrectomy; with thoracic
esophagogastrostomy, with or without pyloroplasty (Ivor Lewis)
43118 Partial esophagectomy, distal two-thirds, with thoracotomy and separate 30-Sep-08 1
abdominal incision, with or without proximal gastrectomy; with colon
interposition or small intestine reconstruction, including intestine mobilization,
preparation, and anastomosis(es)
43121 Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without 30-Sep-08 1
proximal gastrectomy, with thoracic esophagogastrostomy, with or without
pyloroplasty
43122 Partial esophagectomy, thoracoabdominal or abdominal approach, with or 30-Sep-08 1
without proximal gastrectomy; with esophagogastrostomy, with or without
pyloroplasty
43123 Partial esophagectomy, thoracoabdominal or abdominal approach, with or 30-Sep-08 1
without proximal gastrectomy; with colon interposition or small intestine
reconstruction, including intestine mobilization, preparation, and
anastomosis(es)
43124 Total or partial esophagectomy, without reconstruction (any approach), with 30-Sep-08 1
cervical esophagostomy
43130 Diverticulectomy of hypopharynx or esophagus, with or without myotomy; 30-Sep-08 1
cervical approach
43135 Diverticulectomy of hypopharynx or esophagus, with or without myotomy; 30-Sep-08 1
thoracic approach
43200 Esophagoscopy, rigid or flexible; diagnostic, with or without collection of 30-Sep-08 1
specimen(s) by brushing or washing (separate procedure)
43201 Esophagoscopy, rigid or flexible; with directed submucosal injection(s), any 30-Sep-08 1
substance
43202 Esophagoscopy, rigid or flexible; with biopsy, single or multiple 30-Sep-08 1
43204 Esophagoscopy, rigid or flexible; with injection sclerosis of esophageal varices 30-Sep-08 1
43205 Esophagoscopy, rigid or flexible; with band ligation of esophageal varices 30-Sep-08 1
43215 Esophagoscopy, rigid or flexible; with removal of foreign body 30-Sep-08 1

43216 Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s) by hot biopsy forceps or bipolar cautery
43217 Esophagoscopy, rigid or flexible; with removal of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s) by snare technique
43219 Esophagoscopy, rigid or flexible; with insertion of plastic tube or stent 30-Sep-08 1
43220 Esophagoscopy, rigid or flexible; with balloon dilation (less than 30 mm 30-Sep-08 1
diameter)
43226 Esophagoscopy, rigid or flexible; with insertion of guide wire followed by dilation 30-Sep-08 1
over guide wire
43227 Esophagoscopy, rigid or flexible; with control of bleeding (eg, injection, bipolar 30-Sep-08 2
cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator)
43228 Esophagoscopy, rigid or flexible; with ablation of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or
snare technique
43231 Esophagoscopy, rigid or flexible; with endoscopic ultrasound examination 30-Sep-08 1
43232 Esophagoscopy, rigid or flexible; with transendoscopic ultrasound-guided 30-Sep-08 1

intramural or transmural fine needle aspiration/biopsy(s)
43234 Upper gastrointestinal endoscopy, simple primary examination (eg, with small 30-Sep-08 1
diameter flexible endoscope) (separate procedure)
43235 Upper gastrointestinal endoscopy including esophagus, stomach, and either the 30-Sep-08 1
duodenum and/or jejunum as appropriate; diagnostic, with or without collection
of specimen(s) by brushing or washing (separate procedure)
duodenum and/or jejunum as appropriate; with directed submucosal injection(s),
any substance
duodenum and/or jejunum as appropriate; with endoscopic ultrasound
examination limited to the esophagus
duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-
guided intramural or transmural fine needle aspiration/biopsy(s), esophagus
(includes endoscopic ultrasound examination limited to the esophagus)
duodenum and/or jejunum as appropriate; with biopsy, single or multiple
duodenum and/or jejunum as appropriate; with transmural drainage of
pseudocyst
duodenum and/or jejunum as appropriate; with transendoscopic intraluminal
tube or catheter placement
duodenum and/or jejunum as appropriate; with transendoscopic ultrasound-
guided intramural or transmural fine needle aspiration/biopsy(s) (includes
endoscopic ultrasound examination of the esophagus, stomach, and either the
duodenum and/or jejunum as appropriate)
duodenum and/or jejunum as appropriate; with injection sclerosis of esophageal
and/or gastric varices
duodenum and/or jejunum as appropriate; with band ligation of esophageal
and/or gastric varices
duodenum and/or jejunum as appropriate; with dilation of gastric outlet for
obstruction (eg, balloon, guide wire, bougie)
duodenum and/or jejunum as appropriate; with directed placement of
percutaneous gastrostomy tube
duodenum and/or jejunum as appropriate; with removal of foreign body
duodenum and/or jejunum as appropriate; with insertion of guide wire followed
by dilation of esophagus over guide wire
duodenum and/or jejunum as appropriate; with balloon dilation of esophagus
(less than 30 mm diameter)
duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or
other lesion(s) by hot biopsy forceps or bipolar cautery
duodenum and/or jejunum as appropriate; with removal of tumor(s), polyp(s), or
other lesion(s) by snare technique
duodenum and/or jejunum as appropriate; with control of bleeding, any method
duodenum and/or jejunum as appropriate; with transendoscopic stent placement
(includes predilation)
duodenum and/or jejunum as appropriate; with delivery of thermal energy to the
muscle of lower esophageal sphincter and/or gastric cardia, for treatment of
gastroesophageal reflux disease
duodenum and/or jejunum as appropriate; with ablation of tumor(s), polyp(s), or
other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or
snare technique
duodenum and/or jejunum as appropriate; with endoscopic ultrasound
examination, including the esophagus, stomach, and either the duodenum
and/or jejunum as appropriate
43260 Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or 30-Sep-08 1
without collection of specimen(s) by brushing or washing (separate procedure)
43261 Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, single or 30-Sep-08 1

multiple
43262 Endoscopic retrograde cholangiopancreatography (ERCP); with 30-Sep-08 2
sphincterotomy/papillotomy
43263 Endoscopic retrograde cholangiopancreatography (ERCP); with pressure 30-Sep-08 2
measurement of sphincter of Oddi (pancreatic duct or common bile duct)
43264 Endoscopic retrograde cholangiopancreatography (ERCP); with endoscopic 30-Sep-08 1

retrograde removal of calculus/calculi from biliary and/or pancreatic ducts

retrograde destruction, lithotripsy of calculus/calculi, any method

retrograde insertion of nasobiliary or nasopancreatic drainage tube

retrograde insertion of tube or stent into bile or pancreatic duct

retrograde removal of foreign body and/or change of tube or stent

retrograde balloon dilation of ampulla, biliary and/or pancreatic duct(s)
43272 Endoscopic retrograde cholangiopancreatography (ERCP); with ablation of 30-Sep-08 1

tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy
forceps, bipolar cautery or snare technique
43273 Endoscopic cannulation of papilla with direct visualization of common bile 15-Oct-12 1
duct(s) and/or pancreatic duct(s) (List separately in addition to code(s) for
primary procedure)
43279 Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when 15-Oct-12
performed
43280 Laparoscopy, surgical, esophagogastric fundoplasty (eg, Nissen, Toupet 30-Sep-08 1
procedures)
43281 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, 15-Oct-12
when performed; without implantation of mesh
43282 Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, 15-Oct-12
when performed; with implantation of mesh
43283 Laparoscopy, surgical, esophageal lengthening procedure (eg, Collis gastroplasty 15-Oct-12 1
or wedge gastroplasty) (List separately in addition to code for primary
procedure)
43289 Unlisted laparoscopy procedure, esophagus 30-Sep-08
43300 Esophagoplasty (plastic repair or reconstruction), cervical approach; without 30-Sep-08 1

repair of tracheoesophageal fistula
43305 Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair 30-Sep-08 1
of tracheoesophageal fistula
43310 Esophagoplasty (plastic repair or reconstruction), thoracic approach; without 30-Sep-08 1
repair of tracheoesophageal fistula
43312 Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair 30-Sep-08 1
of tracheoesophageal fistula
43313 Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic 30-Sep-08 1
approach; without repair of congenital tracheoesophageal fistula
43314 Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic 30-Sep-08 1
approach; with repair of congenital tracheoesophageal fistula
43320 Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, 30-Sep-08 1

transabdominal or transthoracic approach
43324 Esophagogastric fundoplasty (eg, Nissen, Belsey IV, Hill procedures) 30-Sep-08 14-Oct-12
43325 Esophagogastric fundoplasty, with fundic patch (Thal-Nissen procedure) 30-Sep-08 1
43326 Esophagogastric fundoplasty; with gastroplasty (eg, Collis) 30-Sep-08 14-Oct-12

43327 Esophagogastric fundoplasty partial or complete; laparotomy 15-Oct-12 1
43328 Esophagogastric fundoplasty partial or complete; thoracotomy 15-Oct-12 1
43330 Esophagomyotomy (Heller type); abdominal approach 30-Sep-08 1
43331 Esophagomyotomy (Heller type); thoracic approach 30-Sep-08 1
43332 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, 15-Oct-12 1
except neonatal; without implantation of mesh or other prosthesis
43333 Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, 15-Oct-12 1
except neonatal; with implantation of mesh or other prosthesis
43334 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, 15-Oct-12 1
except neonatal; without implantation of mesh or other prosthesis
43335 Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, 15-Oct-12 1
except neonatal; with implantation of mesh or other prosthesis
43336 Repair, paraesophageal hiatal hernia, (including fundoplication), via 15-Oct-12 1

thoracoabdominal incision, except neonatal; without implantation of mesh or
other prosthesis
43337 Repair, paraesophageal hiatal hernia, (including fundoplication), via 15-Oct-12 1
thoracoabdominal incision, except neonatal; with implantation of mesh or other
prosthesis
43338 Esophageal lengthening procedure (eg, Collis gastroplasty or wedge 15-Oct-12 1
gastroplasty) (List separately in addition to code for primary procedure)
43340 Esophagojejunostomy (without total gastrectomy); abdominal approach 30-Sep-08 1
43341 Esophagojejunostomy (without total gastrectomy); thoracic approach 30-Sep-08 1

43350 Esophagostomy, fistulization of esophagus, external; abdominal approach 30-Sep-08 1
43351 Esophagostomy, fistulization of esophagus, external; thoracic approach 30-Sep-08 1
43352 Esophagostomy, fistulization of esophagus, external; cervical approach 30-Sep-08 1
43360 Gastrointestinal reconstruction for previous esophagectomy, for obstructing 30-Sep-08 1

esophageal lesion or fistula, or for previous esophageal exclusion; with stomach,
with or without pyloroplasty
43361 Gastrointestinal reconstruction for previous esophagectomy, for obstructing 30-Sep-08 1
esophageal lesion or fistula, or for previous esophageal exclusion; with colon
interposition or small intestine reconstruction, including intestine mobilization,
preparation, and anastomosis(es)
43400 Ligation, direct, esophageal varices 30-Sep-08 1
43401 Transection of esophagus with repair, for esophageal varices 30-Sep-08 1
43405 Ligation or stapling at gastroesophageal junction for pre-existing esophageal 30-Sep-08 1
perforation
43410 Suture of esophageal wound or injury; cervical approach 30-Sep-08 1
43415 Suture of esophageal wound or injury; transthoracic or transabdominal approach 30-Sep-08 1
43420 Closure of esophagostomy or fistula; cervical approach 30-Sep-08 1

43425 Closure of esophagostomy or fistula; transthoracic or transabdominal approach 30-Sep-08 1
43450 Dilation of esophagus, by unguided sound or bougie, single or multiple passes 30-Sep-08 1
43453 Dilation of esophagus, over guide wire 30-Sep-08 1

43456 Dilation of esophagus, by balloon or dilator, retrograde 30-Sep-08 1
43458 Dilation of esophagus with balloon (30 mm diameter or larger) for achalasia 30-Sep-08 1
43460 Esophagogastric tamponade, with balloon (Sengstaken type) 30-Sep-08 1

43496 Free jejunum transfer with microvascular anastomosis 30-Sep-08 1
43499 Unlisted procedure, esophagus 30-Sep-08
43500 Gastrotomy; with exploration or foreign body removal 30-Sep-08 1

43501 Gastrotomy; with suture repair of bleeding ulcer 30-Sep-08 1
43502 Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, 30-Sep-08 1
Mallory-Weiss)
43510 Gastrotomy; with esophageal dilation and insertion of permanent intraluminal 30-Sep-08 1
tube (eg, Celestin or Mousseaux-Barbin)
43520 Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) 30-Sep-08 1
43600 Biopsy of stomach; by capsule, tube, peroral (one or more specimens) 30-Sep-08 14-Oct-12
43605 Biopsy of stomach, by laparotomy 30-Sep-08 1
43610 Excision, local; ulcer or benign tumor of stomach 30-Sep-08 1
43611 Excision, local; malignant tumor of stomach 30-Sep-08 1
43620 Gastrectomy, total; with esophagoenterostomy 30-Sep-08 1
43621 Gastrectomy, total; with Roux-en-Y reconstruction 30-Sep-08 1
43622 Gastrectomy, total; with formation of intestinal pouch, any type 30-Sep-08 1
43631 Gastrectomy, partial, distal; with gastroduodenostomy 30-Sep-08 1
43632 Gastrectomy, partial, distal; with gastrojejunostomy 30-Sep-08 1
43633 Gastrectomy, partial, distal; with Roux-en-Y reconstruction 30-Sep-08 1
43634 Gastrectomy, partial, distal; with formation of intestinal pouch 30-Sep-08 1
43635 Vagotomy when performed with partial distal gastrectomy (List separately in 30-Sep-08 1
addition to code[s] for primary procedure)
43640 Vagotomy including pyloroplasty, with or without gastrostomy; truncal or 30-Sep-08 1
selective
43641 Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell 30-Sep-08 1
(highly selective)
43644 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and 30-Sep-08 1
Roux-en-Y gastroenterostomy (roux limb 150 cm or less)
43645 Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and 30-Sep-08 1
small intestine reconstruction to limit absorption
43647 Laparoscopy, surgical; implantation or replacement of gastric neurostimulator 30-Sep-08 1
electrodes, antrum
43648 Laparoscopy, surgical; revision or removal of gastric neurostimulator electrodes, 30-Sep-08 1
antrum
43651 Laparoscopy, surgical; transection of vagus nerves, truncal 30-Sep-08 1
43652 Laparoscopy, surgical; transection of vagus nerves, selective or highly selective 30-Sep-08 1
43653 Laparoscopy, surgical; gastrostomy, without construction of gastric tube (eg, 30-Sep-08 1
Stamm procedure) (separate procedure)
43659 Unlisted laparoscopy procedure, stomach 30-Sep-08
43752 Naso- or oro-gastric tube placement, requiring physician's skill and fluoroscopic 30-Sep-08 2
guidance (includes fluoroscopy, image documentation and report)
43753 Gastric intubation and aspiration(s) therapeutic, necessitating physician's skill 15-Oct-12 1
(eg, for gastrointestinal hemorrhage), including lavage if performed
43754 Gastric intubation and aspiration, diagnostic; single specimen (eg, acid analysis) 15-Oct-12 1
43755 Gastric intubation and aspiration, diagnostic; collection of multiple fractional 15-Oct-12 1
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 15-Oct-12 1
specimen (eg, bile study for crystals or afferent loop culture)
43757 Duodenal intubation and aspiration, diagnostic, includes image guidance; 15-Oct-12 1
collection of multiple fractional specimens with pancreatic or gallbladder
stimulation, single or double lumen tube, includes drug administration
43760 Change of gastrostomy tube, percutaneous, without imaging or endoscopic 30-Sep-08 2

guidance
43761 Repositioning of a naso- or oro-gastric feeding tube, through the duodenum for 30-Sep-08 2
enteric nutrition
43770 Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable 30-Sep-08 1
gastric restrictive device (eg, gastric band and subcutaneous port components)
43771 Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric 30-Sep-08 1
restrictive device component only
43772 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable 30-Sep-08 1
gastric restrictive device component only
43773 Laparoscopy, surgical, gastric restrictive procedure; removal and replacement of 30-Sep-08 1
adjustable gastric restrictive device component only
43774 Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable 30-Sep-08 1
gastric restrictive device and subcutaneous port components
43775 Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, 15-Oct-12
sleeve gastrectomy)
43800 Pyloroplasty 30-Sep-08 1
43810 Gastroduodenostomy 30-Sep-08 1
43820 Gastrojejunostomy; without vagotomy 30-Sep-08 1
43825 Gastrojejunostomy; with vagotomy, any type 30-Sep-08 1
43830 Gastrostomy, open; without construction of gastric tube (eg, Stamm procedure) 30-Sep-08 1
43831 Gastrostomy, open; neonatal, for feeding 30-Sep-08 1
43832 Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) 30-Sep-08 1
43840 Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury 30-Sep-08 2
43842 Gastric restrictive procedure, without gastric bypass, for morbid obesity; vertical- 30-Sep-08
banded gastroplasty
43843 Gastric restrictive procedure, without gastric bypass, for morbid obesity; other 30-Sep-08 1
than vertical-banded gastroplasty
43845 Gastric restrictive procedure with partial gastrectomy, pylorus-preserving 30-Sep-08 1
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 30-Sep-08 1
limb (150 cm or less) Roux-en-Y gastroenterostomy
43847 Gastric restrictive procedure, with gastric bypass for morbid obesity; with small 30-Sep-08 1
intestine reconstruction to limit absorption
43848 Revision, open, of gastric restrictive procedure for morbid obesity, other than 30-Sep-08 1
adjustable gastric restrictive device (separate procedure)
43850 Revision of gastroduodenal anastomosis (gastroduodenostomy) with 30-Sep-08 1
reconstruction; without vagotomy
43855 Revision of gastroduodenal anastomosis (gastroduodenostomy) with 30-Sep-08 1
reconstruction; with vagotomy
43860 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, 30-Sep-08 1
with or without partial gastrectomy or intestine resection; without vagotomy
43865 Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, 30-Sep-08 1
with or without partial gastrectomy or intestine resection; with vagotomy
43870 Closure of gastrostomy, surgical 30-Sep-08 1

43880 Closure of gastrocolic fistula 30-Sep-08 1
43881 Implantation or replacement of gastric neurostimulator electrodes, antrum, open 30-Sep-08 1
43882 Revision or removal of gastric neurostimulator electrodes, antrum, open 30-Sep-08 1
43886 Gastric restrictive procedure, open; revision of subcutaneous port component 30-Sep-08 1
only
43887 Gastric restrictive procedure, open; removal of subcutaneous port component 30-Sep-08 1
only
43888 Gastric restrictive procedure, open; removal and replacement of subcutaneous 30-Sep-08 1
port component only
43999 Unlisted procedure, stomach 30-Sep-08
44005 Enterolysis (freeing of intestinal adhesion) (separate procedure) 30-Sep-08 1

44010 Duodenotomy, for exploration, biopsy(s), or foreign body removal 30-Sep-08 1
44015 Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any 30-Sep-08 1
method (List separately in addition to primary procedure)
44020 Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or 30-Sep-08 2
foreign body removal
44021 Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker 30-Sep-08 1
tube)
44025 Colotomy, for exploration, biopsy(s), or foreign body removal 30-Sep-08 1
44050 Reduction of volvulus, intussusception, internal hernia, by laparotomy 30-Sep-08 1
44055 Correction of malrotation by lysis of duodenal bands and/or reduction of midgut 30-Sep-08 1
volvulus (eg, Ladd procedure)
44100 Biopsy of intestine by capsule, tube, peroral (1 or more specimens) 30-Sep-08 1
44110 Excision of 1 or more lesions of small or large intestine not requiring 30-Sep-08 1
anastomosis, exteriorization, or fistulization; single enterotomy
44111 Excision of 1 or more lesions of small or large intestine not requiring 30-Sep-08 1
anastomosis, exteriorization, or fistulization; multiple enterotomies
44120 Enterectomy, resection of small intestine; single resection and anastomosis 30-Sep-08 1
44121 Enterectomy, resection of small intestine; each additional resection and 30-Sep-08
anastomosis (List separately in addition to code for primary procedure)
44125 Enterectomy, resection of small intestine; with enterostomy 30-Sep-08 1

44126 Enterectomy, resection of small intestine for congenital atresia, single resection 30-Sep-08 1
and anastomosis of proximal segment of intestine; without tapering
and anastomosis of proximal segment of intestine; with tapering
and anastomosis of proximal segment of intestine; each additional resection and
anastomosis (List separately in addition to code for primary procedure)
44130 Enteroenterostomy, anastomosis of intestine, with or without cutaneous 30-Sep-08

enterostomy (separate procedure)
44132 Donor enterectomy (including cold preservation), open; from cadaver donor 30-Sep-08 1
44133 Donor enterectomy (including cold preservation), open; partial, from living donor 30-Sep-08 1
44135 Intestinal allotransplantation; from cadaver donor 30-Sep-08 1
44136 Intestinal allotransplantation; from living donor 30-Sep-08 1
44137 Removal of transplanted intestinal allograft, complete 30-Sep-08 1
44139 Mobilization (take-down) of splenic flexure performed in conjunction with partial 30-Sep-08 1
colectomy (List separately in addition to primary procedure)
44140 Colectomy, partial; with anastomosis 30-Sep-08 2

44141 Colectomy, partial; with skin level cecostomy or colostomy 30-Sep-08 1
44143 Colectomy, partial; with end colostomy and closure of distal segment (Hartmann 30-Sep-08 1
type procedure)
44144 Colectomy, partial; with resection, with colostomy or ileostomy and creation of 30-Sep-08 1
mucofistula
44145 Colectomy, partial; with coloproctostomy (low pelvic anastomosis) 30-Sep-08 1
44146 Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with 30-Sep-08 1
colostomy
44147 Colectomy, partial; abdominal and transanal approach 30-Sep-08 1
44150 Colectomy, total, abdominal, without proctectomy; with ileostomy or 30-Sep-08 1
ileoproctostomy
44151 Colectomy, total, abdominal, without proctectomy; with continent ileostomy 30-Sep-08 1
44155 Colectomy, total, abdominal, with proctectomy; with ileostomy 30-Sep-08 1

44156 Colectomy, total, abdominal, with proctectomy; with continent ileostomy 30-Sep-08 1
44157 Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, 30-Sep-08 1
includes loop ileostomy, and rectal mucosectomy, when performed
44158 Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, 30-Sep-08 1
creation of ileal reservoir (S or J), includes loop ileostomy, and rectal
mucosectomy, when performed
44160 Colectomy, partial, with removal of terminal ileum with ileocolostomy 30-Sep-08 1
44180 Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate 30-Sep-08 1

procedure)
44186 Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) 30-Sep-08 1
44187 Laparoscopy, surgical; ileostomy or jejunostomy, non-tube 30-Sep-08 1

44188 Laparoscopy, surgical, colostomy or skin level cecostomy 30-Sep-08 1
44202 Laparoscopy, surgical; enterectomy, resection of small intestine, single resection 30-Sep-08 1
and anastomosis
44203 Laparoscopy, surgical; each additional small intestine resection and anastomosis 30-Sep-08 2
44204 Laparoscopy, surgical; colectomy, partial, with anastomosis 30-Sep-08 2

44205 Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with 30-Sep-08 1
ileocolostomy
44206 Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of 30-Sep-08 1
distal segment (Hartmann type procedure)
44207 Laparoscopy, surgical; colectomy, partial, with anastomosis, with 30-Sep-08 1
coloproctostomy (low pelvic anastomosis)
44208 Laparoscopy, surgical; colectomy, partial, with anastomosis, with 30-Sep-08 1
coloproctostomy (low pelvic anastomosis) with colostomy
44210 Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with 30-Sep-08 1
ileostomy or ileoproctostomy
44211 Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with 30-Sep-08 1
ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy,
includes rectal mucosectomy, when performed
44212 Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with 30-Sep-08 1
ileostomy
44213 Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in 30-Sep-08 1
conjunction with partial colectomy (List separately in addition to primary
procedure)
44227 Laparoscopy, surgical, closure of enterostomy, large or small intestine, with 30-Sep-08 1
resection and anastomosis
44238 Unlisted laparoscopy procedure, intestine (except rectum) 30-Sep-08
44300 Placement, enterostomy or cecostomy, tube open (eg, for feeding or 30-Sep-08 1
decompression) (separate procedure)
44310 Ileostomy or jejunostomy, non-tube 30-Sep-08 2
44312 Revision of ileostomy; simple (release of superficial scar) (separate procedure) 30-Sep-08 1
44314 Revision of ileostomy; complicated (reconstruction in-depth) (separate 30-Sep-08 1

procedure)
44316 Continent ileostomy (Kock procedure) (separate procedure) 30-Sep-08 1
44320 Colostomy or skin level cecostomy; 30-Sep-08 1
44322 Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital 30-Sep-08 1
megacolon) (separate procedure)
44340 Revision of colostomy; simple (release of superficial scar) (separate procedure) 30-Sep-08 1
44345 Revision of colostomy; complicated (reconstruction in-depth) (separate 30-Sep-08 1

procedure)
44346 Revision of colostomy; with repair of paracolostomy hernia (separate procedure) 30-Sep-08 1
44360 Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, 30-Sep-08 1
not including ileum; diagnostic, with or without collection of specimen(s) by
brushing or washing (separate procedure)
not including ileum; with biopsy, single or multiple
not including ileum; with removal of foreign body
not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by
snare technique
not including ileum; with removal of tumor(s), polyp(s), or other lesion(s) by hot
biopsy forceps or bipolar cautery
not including ileum; with control of bleeding (eg, injection, bipolar cautery,
unipolar cautery, laser, heater probe, stapler, plasma coagulator)
not including ileum; with ablation of tumor(s), polyp(s), or other lesion(s) not
amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
not including ileum; with transendoscopic stent placement (includes predilation)
not including ileum; with placement of percutaneous jejunostomy tube
not including ileum; with conversion of percutaneous gastrostomy tube to
percutaneous jejunostomy tube
including ileum; diagnostic, with or without collection of specimen(s) by brushing
or washing (separate procedure)
including ileum; with biopsy, single or multiple
including ileum; with control of bleeding (eg, injection, bipolar cautery, unipolar
cautery, laser, heater probe, stapler, plasma coagulator)
including ileum; with transendoscopic stent placement (includes predilation)
44380 Ileoscopy, through stoma; diagnostic, with or without collection of specimen(s) 30-Sep-08 1
by brushing or washing (separate procedure)
44382 Ileoscopy, through stoma; with biopsy, single or multiple 30-Sep-08 1
44383 Ileoscopy, through stoma; with transendoscopic stent placement (includes 30-Sep-08 1
predilation)
44385 Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; 30-Sep-08 1
diagnostic, with or without collection of specimen(s) by brushing or washing
44386 Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; with 30-Sep-08 1
biopsy, single or multiple
44388 Colonoscopy through stoma; diagnostic, with or without collection of 30-Sep-08 1
specimen(s) by brushing or washing (separate procedure)
44389 Colonoscopy through stoma; with biopsy, single or multiple 30-Sep-08 1
44390 Colonoscopy through stoma; with removal of foreign body 30-Sep-08 1
44391 Colonoscopy through stoma; with control of bleeding (eg, injection, bipolar 30-Sep-08 1
44392 Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s) by hot biopsy forceps or bipolar cautery
44393 Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or
snare technique
44394 Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other 30-Sep-08 1
lesion(s) by snare technique
44397 Colonoscopy through stoma; with transendoscopic stent placement (includes 30-Sep-08 1
predilation)
44500 Introduction of long gastrointestinal tube (eg, Miller-Abbott) (separate procedure) 30-Sep-08 1
44602 Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, 30-Sep-08 1
wound, injury or rupture; single perforation
44603 Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, 30-Sep-08 1
wound, injury or rupture; multiple perforations
44604 Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, 30-Sep-08 1
injury or rupture (single or multiple perforations); without colostomy
44605 Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, 30-Sep-08 1
injury or rupture (single or multiple perforations); with colostomy
44615 Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without 30-Sep-08

dilation, for intestinal obstruction
44620 Closure of enterostomy, large or small intestine; 30-Sep-08 2
44625 Closure of enterostomy, large or small intestine; with resection and anastomosis 30-Sep-08 1
other than colorectal
44626 Closure of enterostomy, large or small intestine; with resection and colorectal 30-Sep-08 1
anastomosis (eg, closure of Hartmann type procedure)
44640 Closure of intestinal cutaneous fistula 30-Sep-08 2
44650 Closure of enteroenteric or enterocolic fistula 30-Sep-08 2
44660 Closure of enterovesical fistula; without intestinal or bladder resection 30-Sep-08 1
44661 Closure of enterovesical fistula; with intestine and/or bladder resection 30-Sep-08 1
44680 Intestinal plication (separate procedure) 30-Sep-08 1

44700 Exclusion of small intestine from pelvis by mesh or other prosthesis, or native 30-Sep-08 1
tissue (eg, bladder or omentum)
44701 Intraoperative colonic lavage (List separately in addition to code for primary 30-Sep-08 1
procedure)
44715 Backbench standard preparation of cadaver or living donor intestine allograft 30-Sep-08 1
prior to transplantation, including mobilization and fashioning of the superior
mesenteric artery and vein
44720 Backbench reconstruction of cadaver or living donor intestine allograft prior to 30-Sep-08 2
transplantation; venous anastomosis, each
44721 Backbench reconstruction of cadaver or living donor intestine allograft prior to 30-Sep-08 2
transplantation; arterial anastomosis, each
44799 Unlisted procedure, intestine 30-Sep-08
44800 Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct 30-Sep-08 1
44820 Excision of lesion of mesentery (separate procedure) 30-Sep-08 2

44850 Suture of mesentery (separate procedure) 30-Sep-08 1
44899 Unlisted procedure, Meckel's diverticulum and the mesentery 30-Sep-08
44900 Incision and drainage of appendiceal abscess; open 30-Sep-08 1

44901 Incision and drainage of appendiceal abscess; percutaneous 30-Sep-08 1
44950 Appendectomy; 30-Sep-08 1
44955 Appendectomy; when done for indicated purpose at time of other major 30-Sep-08 1
procedure (not as separate procedure) (List separately in addition to code for
primary procedure)
44960 Appendectomy; for ruptured appendix with abscess or generalized peritonitis 30-Sep-08 1
44970 Laparoscopy, surgical, appendectomy 30-Sep-08 1

44979 Unlisted laparoscopy procedure, appendix 30-Sep-08
45000 Transrectal drainage of pelvic abscess 30-Sep-08 1

45005 Incision and drainage of submucosal abscess, rectum 30-Sep-08 1
45020 Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess 30-Sep-08 1
45100 Biopsy of anorectal wall, anal approach (eg, congenital megacolon) 30-Sep-08 1
45108 Anorectal myomectomy 30-Sep-08 1
45110 Proctectomy; complete, combined abdominoperineal, with colostomy 30-Sep-08 1
45111 Proctectomy; partial resection of rectum, transabdominal approach 30-Sep-08 1

45112 Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal 30-Sep-08 1
anastomosis)
45113 Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of 30-Sep-08 1
ileal reservoir (S or J), with or without loop ileostomy
45114 Proctectomy, partial, with anastomosis; abdominal and transsacral approach 30-Sep-08 1
45116 Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) 30-Sep-08 1
45119 Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal 30-Sep-08 1

anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting
enterostomy when performed
45120 Proctectomy, complete (for congenital megacolon), abdominal and perineal 30-Sep-08 1
approach; with pull-through procedure and anastomosis (eg, Swenson, Duhamel,
or Soave type operation)
45121 Proctectomy, complete (for congenital megacolon), abdominal and perineal 30-Sep-08 1
approach; with subtotal or total colectomy, with multiple biopsies
45123 Proctectomy, partial, without anastomosis, perineal approach 30-Sep-08 1

45126 Pelvic exenteration for colorectal malignancy, with proctectomy (with or without 30-Sep-08 1
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 30-Sep-08 1

45135 Excision of rectal procidentia, with anastomosis; abdominal and perineal 30-Sep-08 1
approach
45136 Excision of ileoanal reservoir with ileostomy 30-Sep-08 1
45150 Division of stricture of rectum 30-Sep-08 1
45160 Excision of rectal tumor by proctotomy, transsacral or transcoccygeal approach 30-Sep-08 1
45170 Excision of rectal tumor, transanal approach 30-Sep-08 14-Oct-12

45171 Excision of rectal tumor, transanal approach; not including muscularis propria 15-Oct-12
(ie, partial thickness)
45172 Excision of rectal tumor, transanal approach; including muscularis propria (ie, full 15-Oct-12
thickness)
45190 Destruction of rectal tumor (eg, electrodesiccation, electrosurgery, laser 30-Sep-08 1
ablation, laser resection, cryosurgery) transanal approach
45300 Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) 30-Sep-08 1
by brushing or washing (separate procedure)
45303 Proctosigmoidoscopy, rigid; with dilation (eg, balloon, guide wire, bougie) 30-Sep-08 1
45305 Proctosigmoidoscopy, rigid; with biopsy, single or multiple 30-Sep-08 1

45307 Proctosigmoidoscopy, rigid; with removal of foreign body 30-Sep-08 1
45308 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion 30-Sep-08 1
by hot biopsy forceps or bipolar cautery
45309 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion 30-Sep-08 1
by snare technique
45315 Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps, or other 30-Sep-08 1
lesions by hot biopsy forceps, bipolar cautery or snare technique
45317 Proctosigmoidoscopy, rigid; with control of bleeding (eg, injection, bipolar 30-Sep-08 1
45320 Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s), or other lesion(s) 30-Sep-08 1
not amenable to removal by hot biopsy forceps, bipolar cautery or snare
technique (eg, laser)
45321 Proctosigmoidoscopy, rigid; with decompression of volvulus 30-Sep-08 1
45327 Proctosigmoidoscopy, rigid; with transendoscopic stent placement (includes 30-Sep-08 1
predilation)
45330 Sigmoidoscopy, flexible; diagnostic, with or without collection of specimen(s) by 30-Sep-08 1
brushing or washing (separate procedure)
45331 Sigmoidoscopy, flexible; with biopsy, single or multiple 30-Sep-08 1
45332 Sigmoidoscopy, flexible; with removal of foreign body 30-Sep-08 1
45333 Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by 30-Sep-08 1
hot biopsy forceps or bipolar cautery
45334 Sigmoidoscopy, flexible; with control of bleeding (eg, injection, bipolar cautery, 30-Sep-08 1
unipolar cautery, laser, heater probe, stapler, plasma coagulator)
45335 Sigmoidoscopy, flexible; with directed submucosal injection(s), any substance 30-Sep-08 1
45337 Sigmoidoscopy, flexible; with decompression of volvulus, any method 30-Sep-08 1
45338 Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by 30-Sep-08 1
snare technique
45339 Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other lesion(s) not 30-Sep-08 1
amenable to removal by hot biopsy forceps, bipolar cautery or snare technique
45340 Sigmoidoscopy, flexible; with dilation by balloon, 1 or more strictures 30-Sep-08 1

45341 Sigmoidoscopy, flexible; with endoscopic ultrasound examination 30-Sep-08 1
45342 Sigmoidoscopy, flexible; with transendoscopic ultrasound guided intramural or 30-Sep-08 1
transmural fine needle aspiration/biopsy(s)
45345 Sigmoidoscopy, flexible; with transendoscopic stent placement (includes 30-Sep-08 1
predilation)
45355 Colonoscopy, rigid or flexible, transabdominal via colotomy, single or multiple 30-Sep-08 1
45378 Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without 30-Sep-08 1
collection of specimen(s) by brushing or washing, with or without colon
decompression (separate procedure)
45379 Colonoscopy, flexible, proximal to splenic flexure; with removal of foreign body 30-Sep-08 1
45380 Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple 30-Sep-08 1
45381 Colonoscopy, flexible, proximal to splenic flexure; with directed submucosal 30-Sep-08 1
injection(s), any substance
45382 Colonoscopy, flexible, proximal to splenic flexure; with control of bleeding (eg, 30-Sep-08 2
injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma
coagulator)
45383 Colonoscopy, flexible, proximal to splenic flexure; with ablation of tumor(s), 30-Sep-08 1
polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps,
bipolar cautery or snare technique
45384 Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), 30-Sep-08 1
polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery
45385 Colonoscopy, flexible, proximal to splenic flexure; with removal of tumor(s), 30-Sep-08 1
polyp(s), or other lesion(s) by snare technique
45386 Colonoscopy, flexible, proximal to splenic flexure; with dilation by balloon, 1 or 30-Sep-08 1
more strictures
45387 Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic stent 30-Sep-08 1
placement (includes predilation)
45391 Colonoscopy, flexible, proximal to splenic flexure; with endoscopic ultrasound 30-Sep-08 1
examination
45392 Colonoscopy, flexible, proximal to splenic flexure; with transendoscopic 30-Sep-08 1
ultrasound guided intramural or transmural fine needle aspiration/biopsy(s)
45395 Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, 30-Sep-08 1

with colostomy
45397 Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through 30-Sep-08 1
procedure (eg, colo-anal anastomosis), with creation of colonic reservoir (eg, J-
pouch), with diverting enterostomy, when performed
45400 Laparoscopy, surgical; proctopexy (for prolapse) 30-Sep-08 1

45402 Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection 30-Sep-08 1
45499 Unlisted laparoscopy procedure, rectum 30-Sep-08
45500 Proctoplasty; for stenosis 30-Sep-08 1

45505 Proctoplasty; for prolapse of mucous membrane 30-Sep-08 1
45520 Perirectal injection of sclerosing solution for prolapse 30-Sep-08 1
45540 Proctopexy (eg, for prolapse); abdominal approach 30-Sep-08 1
45541 Proctopexy (eg, for prolapse); perineal approach 30-Sep-08 1
45550 Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach 30-Sep-08 1
45560 Repair of rectocele (separate procedure) 30-Sep-08 1

45562 Exploration, repair, and presacral drainage for rectal injury; 30-Sep-08 1
45563 Exploration, repair, and presacral drainage for rectal injury; with colostomy 30-Sep-08 1
45800 Closure of rectovesical fistula; 30-Sep-08 1

45805 Closure of rectovesical fistula; with colostomy 30-Sep-08 1
45820 Closure of rectourethral fistula; 30-Sep-08 1
45825 Closure of rectourethral fistula; with colostomy 30-Sep-08 1
45900 Reduction of procidentia (separate procedure) under anesthesia 30-Sep-08 1
45905 Dilation of anal sphincter (separate procedure) under anesthesia other than local 30-Sep-08 1
45910 Dilation of rectal stricture (separate procedure) under anesthesia other than local 30-Sep-08 1
45915 Removal of fecal impaction or foreign body (separate procedure) under 30-Sep-08 1
anesthesia
45990 Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), 30-Sep-08 1
diagnostic
45999 Unlisted procedure, rectum 30-Sep-08
46020 Placement of seton 30-Sep-08 1

46030 Removal of anal seton, other marker 30-Sep-08 1
46040 Incision and drainage of ischiorectal and/or perirectal abscess (separate 30-Sep-08 2
procedure)
46045 Incision and drainage of intramural, intramuscular, or submucosal abscess, 30-Sep-08 2
transanal, under anesthesia
46050 Incision and drainage, perianal abscess, superficial 30-Sep-08 2
46060 Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or 30-Sep-08 2
fistulotomy, submuscular, with or without placement of seton
46070 Incision, anal septum (infant) 30-Sep-08 1

46080 Sphincterotomy, anal, division of sphincter (separate procedure) 30-Sep-08 1
46083 Incision of thrombosed hemorrhoid, external 30-Sep-08 2
46200 Fissurectomy, including sphincterotomy, when performed 30-Sep-08 1
46210 Cryptectomy; single 30-Sep-08 14-Oct-12
46211 Cryptectomy; multiple (separate procedure) 30-Sep-08 14-Oct-12
46220 Excision of single external papilla or tag, anus 30-Sep-08 2
46221 Hemorrhoidectomy, internal, by rubber band ligation(s) 30-Sep-08 1
46230 Excision of multiple external papillae or tags, anus 30-Sep-08 1
46250 Hemorrhoidectomy, external, 2 or more columns/groups 30-Sep-08 1
46255 Hemorrhoidectomy, internal and external, single column/group; 30-Sep-08 1
46257 Hemorrhoidectomy, internal and external, single column/group; with 30-Sep-08 1
fissurectomy
46258 Hemorrhoidectomy, internal and external, single column/group; with 30-Sep-08 1
fistulectomy, including fissurectomy, when performed
46260 Hemorrhoidectomy, internal and external, 2 or more columns/groups; 30-Sep-08 1
46261 Hemorrhoidectomy, internal and external, 2 or more columns/groups; with 30-Sep-08 1
fissurectomy
46262 Hemorrhoidectomy, internal and external, 2 or more columns/groups; with 30-Sep-08 1
fistulectomy, including fissurectomy, when performed
46270 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous 30-Sep-08 1
46275 Surgical treatment of anal fistula (fistulectomy/fistulotomy); intersphincteric 30-Sep-08 1
46280 Surgical treatment of anal fistula (fistulectomy/fistulotomy); transsphincteric, 30-Sep-08 1

suprasphincteric, extrasphincteric or multiple, including placement of seton,
when performed
46285 Surgical treatment of anal fistula (fistulectomy/fistulotomy); second stage 30-Sep-08 1
46288 Closure of anal fistula with rectal advancement flap 30-Sep-08 1

46320 Excision of thrombosed hemorrhoid, external 30-Sep-08 2
46500 Injection of sclerosing solution, hemorrhoids 30-Sep-08 1
46505 Chemodenervation of internal anal sphincter 30-Sep-08 1
46600 Anoscopy; diagnostic, with or without collection of specimen(s) by brushing or 30-Sep-08 1
washing (separate procedure)
46604 Anoscopy; with dilation (eg, balloon, guide wire, bougie) 30-Sep-08 1
46606 Anoscopy; with biopsy, single or multiple 30-Sep-08 1
46608 Anoscopy; with removal of foreign body 30-Sep-08 1
46610 Anoscopy; with removal of single tumor, polyp, or other lesion by hot biopsy 30-Sep-08 1
forceps or bipolar cautery
46611 Anoscopy; with removal of single tumor, polyp, or other lesion by snare 30-Sep-08 1
technique
46612 Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot 30-Sep-08 1
biopsy forceps, bipolar cautery or snare technique
46614 Anoscopy; with control of bleeding (eg, injection, bipolar cautery, unipolar 30-Sep-08 1
cautery, laser, heater probe, stapler, plasma coagulator)
46615 Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to 30-Sep-08 1
removal by hot biopsy forceps, bipolar cautery or snare technique
46700 Anoplasty, plastic operation for stricture; adult 30-Sep-08 1

46705 Anoplasty, plastic operation for stricture; infant 30-Sep-08 1
46706 Repair of anal fistula with fibrin glue 30-Sep-08 2
46707 Repair of anorectal fistula with plug (eg, porcine small intestine submucosa [SIS]) 15-Oct-12
46710 Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch 30-Sep-08 1
advancement; transperineal approach
46712 Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch 30-Sep-08 1
advancement; combined transperineal and transabdominal approach
46715 Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) 30-Sep-08 1
46716 Repair of low imperforate anus; with transposition of anoperineal or 30-Sep-08 1

anovestibular fistula
46730 Repair of high imperforate anus without fistula; perineal or sacroperineal 30-Sep-08 1
approach
46735 Repair of high imperforate anus without fistula; combined transabdominal and 30-Sep-08 1
sacroperineal approaches
46740 Repair of high imperforate anus with rectourethral or rectovaginal fistula; 30-Sep-08 1
perineal or sacroperineal approach
46742 Repair of high imperforate anus with rectourethral or rectovaginal fistula; 30-Sep-08 1
combined transabdominal and sacroperineal approaches
46744 Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, 30-Sep-08 1
sacroperineal approach
46746 Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined 30-Sep-08 1
abdominal and sacroperineal approach;
46748 Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined 30-Sep-08 1
abdominal and sacroperineal approach; with vaginal lengthening by intestinal
graft or pedicle flaps
46750 Sphincteroplasty, anal, for incontinence or prolapse; adult 30-Sep-08 1
46751 Sphincteroplasty, anal, for incontinence or prolapse; child 30-Sep-08 1
46753 Graft (Thiersch operation) for rectal incontinence and/or prolapse 30-Sep-08 1
46754 Removal of Thiersch wire or suture, anal canal 30-Sep-08 1
46760 Sphincteroplasty, anal, for incontinence, adult; muscle transplant 30-Sep-08 1
46761 Sphincteroplasty, anal, for incontinence, adult; levator muscle imbrication (Park 30-Sep-08 1
posterior anal repair)
46762 Sphincteroplasty, anal, for incontinence, adult; implantation artificial sphincter 30-Sep-08 1
46900 Destruction of lesion(s), anus (eg, condyloma, papilloma, molluscum 30-Sep-08 1

contagiosum, herpetic vesicle), simple; chemical
contagiosum, herpetic vesicle), simple; electrodesiccation
contagiosum, herpetic vesicle), simple; cryosurgery
contagiosum, herpetic vesicle), simple; laser surgery
contagiosum, herpetic vesicle), simple; surgical excision
contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery,
cryosurgery, chemosurgery)
46930 Destruction of internal hemorrhoid(s) by thermal energy (eg, infrared 15-Oct-12 1
coagulation, cautery, radiofrequency)
46934 Destruction of hemorrhoids, any method; internal 30-Sep-08 14-Oct-12
46935 Destruction of hemorrhoids, any method; external 30-Sep-08 14-Oct-12
46936 Destruction of hemorrhoids, any method; internal and external 30-Sep-08 14-Oct-12
46937 Cryosurgery of rectal tumor; benign 30-Sep-08 14-Oct-12
46938 Cryosurgery of rectal tumor; malignant 30-Sep-08 14-Oct-12
46940 Curettage or cautery of anal fissure, including dilation of anal sphincter 30-Sep-08 1
(separate procedure); initial
46942 Curettage or cautery of anal fissure, including dilation of anal sphincter 30-Sep-08 1
(separate procedure); subsequent
46945 Hemorrhoidectomy, internal, by ligation other than rubber band; single 30-Sep-08 1
hemorrhoid column/group
46946 Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more 30-Sep-08 1
hemorrhoid columns/groups
46947 Hemorrhoidopexy (eg, for prolapsing internal hemorrhoids) by stapling 30-Sep-08 1
46999 Unlisted procedure, anus 30-Sep-08
47000 Biopsy of liver, needle; percutaneous 30-Sep-08 3

47001 Biopsy of liver, needle; when done for indicated purpose at time of other major 30-Sep-08 3
procedure (List separately in addition to code for primary procedure)
47010 Hepatotomy; for open drainage of abscess or cyst, 1 or 2 stages 30-Sep-08 3

47011 Hepatotomy; for percutaneous drainage of abscess or cyst, 1 or 2 stages 30-Sep-08 3
47015 Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or 30-Sep-08 1
echinococcal) cyst(s) or abscess(es)
47100 Biopsy of liver, wedge 30-Sep-08 3
47120 Hepatectomy, resection of liver; partial lobectomy 30-Sep-08 1
47122 Hepatectomy, resection of liver; trisegmentectomy 30-Sep-08 1
47125 Hepatectomy, resection of liver; total left lobectomy 30-Sep-08 1
47130 Hepatectomy, resection of liver; total right lobectomy 30-Sep-08 1
47133 Donor hepatectomy (including cold preservation), from cadaver donor 30-Sep-08 1
47135 Liver allotransplantation; orthotopic, partial or whole, from cadaver or living 30-Sep-08 1
donor, any age
47136 Liver allotransplantation; heterotopic, partial or whole, from cadaver or living 30-Sep-08 1
donor, any age
47140 Donor hepatectomy (including cold preservation), from living donor; left lateral 30-Sep-08 1
segment only (segments II and III)
47141 Donor hepatectomy (including cold preservation), from living donor; total left 30-Sep-08 1
lobectomy (segments II, III and IV)
47142 Donor hepatectomy (including cold preservation), from living donor; total right 30-Sep-08 1
lobectomy (segments V, VI, VII and VIII)
47143 Backbench standard preparation of cadaver donor whole liver graft prior to 30-Sep-08 1
allotransplantation, including cholecystectomy, if necessary, and dissection and
removal of surrounding soft tissues to prepare the vena cava, portal vein,
hepatic artery, and common bile duct for implantation; without trisegment or
lobe split
hepatic artery, and common bile duct for implantation; with trisegment split of
whole liver graft into 2 partial liver grafts (ie, left lateral segment [segments II
and III] and right trisegment [segments I and IV through VIII])
hepatic artery, and common bile duct for implantation; with lobe split of whole
liver graft into 2 partial liver grafts (ie, left lobe [segments II, III, and IV] and right
lobe [segments I and V through VIII])
47146 Backbench reconstruction of cadaver or living donor liver graft prior to 30-Sep-08
allotransplantation; venous anastomosis, each
47147 Backbench reconstruction of cadaver or living donor liver graft prior to 30-Sep-08 3
allotransplantation; arterial anastomosis, each
47300 Marsupialization of cyst or abscess of liver 30-Sep-08 2
47350 Management of liver hemorrhage; simple suture of liver wound or injury 30-Sep-08 1
47360 Management of liver hemorrhage; complex suture of liver wound or injury, with 30-Sep-08 1
or without hepatic artery ligation
47361 Management of liver hemorrhage; exploration of hepatic wound, extensive 30-Sep-08 1
debridement, coagulation and/or suture, with or without packing of liver
47362 Management of liver hemorrhage; re-exploration of hepatic wound for removal of 30-Sep-08 1
packing
47370 Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency 30-Sep-08 1
47371 Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical 30-Sep-08 1
47379 Unlisted laparoscopic procedure, liver 30-Sep-08
47380 Ablation, open, of 1 or more liver tumor(s); radiofrequency 30-Sep-08 1

47381 Ablation, open, of 1 or more liver tumor(s); cryosurgical 30-Sep-08 1
47382 Ablation, 1 or more liver tumor(s), percutaneous, radiofrequency 30-Sep-08 1
47399 Unlisted procedure, liver 30-Sep-08
47400 Hepaticotomy or hepaticostomy with exploration, drainage, or removal of 30-Sep-08 1

calculus
47420 Choledochotomy or choledochostomy with exploration, drainage, or removal of 30-Sep-08 1
calculus, with or without cholecystotomy; without transduodenal sphincterotomy
or sphincteroplasty
47425 Choledochotomy or choledochostomy with exploration, drainage, or removal of 30-Sep-08 1
calculus, with or without cholecystotomy; with transduodenal sphincterotomy or
sphincteroplasty
47460 Transduodenal sphincterotomy or sphincteroplasty, with or without 30-Sep-08 1
transduodenal extraction of calculus (separate procedure)
47480 Cholecystotomy or cholecystostomy, open, with exploration, drainage, or 30-Sep-08 1
removal of calculus (separate procedure)
47490 Cholecystostomy, percutaneous, complete procedure, including imaging 30-Sep-08 1
guidance, catheter placement, cholecystogram when performed, and
47500 Injection procedure for percutaneous transhepatic cholangiography 30-Sep-08 2
47505 Injection procedure for cholangiography through an existing catheter (eg, 30-Sep-08 2
percutaneous transhepatic or T-tube)
47510 Introduction of percutaneous transhepatic catheter for biliary drainage 30-Sep-08 2
47511 Introduction of percutaneous transhepatic stent for internal and external biliary 30-Sep-08 2
drainage
47525 Change of percutaneous biliary drainage catheter 30-Sep-08 3
47530 Revision and/or reinsertion of transhepatic tube 30-Sep-08 3
47550 Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition 30-Sep-08 1
47552 Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, with or 30-Sep-08 1
without collection of specimen(s) by brushing and/or washing (separate
procedure)
47553 Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, single or 30-Sep-08 1
multiple
47554 Biliary endoscopy, percutaneous via T-tube or other tract; with removal of 30-Sep-08 1
calculus/calculi
47555 Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary 30-Sep-08 1
duct stricture(s) without stent
47556 Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of biliary 30-Sep-08 1
duct stricture(s) with stent
47560 Laparoscopy, surgical; with guided transhepatic cholangiography, without biopsy 30-Sep-08 1
47561 Laparoscopy, surgical; with guided transhepatic cholangiography with biopsy 30-Sep-08 1
47562 Laparoscopy, surgical; cholecystectomy 30-Sep-08 1

47563 Laparoscopy, surgical; cholecystectomy with cholangiography 30-Sep-08 1
47564 Laparoscopy, surgical; cholecystectomy with exploration of common duct 30-Sep-08 1
47570 Laparoscopy, surgical; cholecystoenterostomy 30-Sep-08 1

47579 Unlisted laparoscopy procedure, biliary tract 30-Sep-08
47600 Cholecystectomy; 30-Sep-08 1

47605 Cholecystectomy; with cholangiography 30-Sep-08 1
47610 Cholecystectomy with exploration of common duct; 30-Sep-08 1
47612 Cholecystectomy with exploration of common duct; with choledochoenterostomy 30-Sep-08 1
47620 Cholecystectomy with exploration of common duct; with transduodenal 30-Sep-08 1

sphincterotomy or sphincteroplasty, with or without cholangiography
47630 Biliary duct stone extraction, percutaneous via T-tube tract, basket, or snare (eg, 30-Sep-08 1
Burhenne technique)
47700 Exploration for congenital atresia of bile ducts, without repair, with or without 30-Sep-08 1
liver biopsy, with or without cholangiography
47701 Portoenterostomy (eg, Kasai procedure) 30-Sep-08 1
47711 Excision of bile duct tumor, with or without primary repair of bile duct; 30-Sep-08 1
extrahepatic
47712 Excision of bile duct tumor, with or without primary repair of bile duct; 30-Sep-08 1
intrahepatic
47715 Excision of choledochal cyst 30-Sep-08 1
47720 Cholecystoenterostomy; direct 30-Sep-08 1
47721 Cholecystoenterostomy; with gastroenterostomy 30-Sep-08 1
47740 Cholecystoenterostomy; Roux-en-Y 30-Sep-08 1
47741 Cholecystoenterostomy; Roux-en-Y with gastroenterostomy 30-Sep-08 1
47760 Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract 30-Sep-08 1
47765 Anastomosis, of intrahepatic ducts and gastrointestinal tract 30-Sep-08 1
47780 Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract 30-Sep-08 1
47785 Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract 30-Sep-08 1
47800 Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis 30-Sep-08 1
47801 Placement of choledochal stent 30-Sep-08 1

47802 U-tube hepaticoenterostomy 30-Sep-08 1
47900 Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) 30-Sep-08 1
47999 Unlisted procedure, biliary tract 30-Sep-08
48000 Placement of drains, peripancreatic, for acute pancreatitis; 30-Sep-08 1

48001 Placement of drains, peripancreatic, for acute pancreatitis; with 30-Sep-08 1
cholecystostomy, gastrostomy, and jejunostomy
48020 Removal of pancreatic calculus 30-Sep-08 1
48100 Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge 30-Sep-08 1
biopsy)
48102 Biopsy of pancreas, percutaneous needle 30-Sep-08 2
48105 Resection or debridement of pancreas and peripancreatic tissue for acute 30-Sep-08
necrotizing pancreatitis
48120 Excision of lesion of pancreas (eg, cyst, adenoma) 30-Sep-08 1
48140 Pancreatectomy, distal subtotal, with or without splenectomy; without 30-Sep-08 1
pancreaticojejunostomy
48145 Pancreatectomy, distal subtotal, with or without splenectomy; with 30-Sep-08 1
pancreaticojejunostomy
48146 Pancreatectomy, distal, near-total with preservation of duodenum (Child-type 30-Sep-08 1
procedure)
48148 Excision of ampulla of Vater 30-Sep-08 1
48150 Pancreatectomy, proximal subtotal with total duodenectomy, partial 30-Sep-08 1
gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type
procedure); with pancreatojejunostomy
48152 Pancreatectomy, proximal subtotal with total duodenectomy, partial 30-Sep-08 1
gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type
procedure); without pancreatojejunostomy
48153 Pancreatectomy, proximal subtotal with near-total duodenectomy, 30-Sep-08 1
choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-
type procedure); with pancreatojejunostomy
48154 Pancreatectomy, proximal subtotal with near-total duodenectomy, 30-Sep-08 1
choledochoenterostomy and duodenojejunostomy (pylorus-sparing, Whipple-
type procedure); without pancreatojejunostomy
48155 Pancreatectomy, total 30-Sep-08 1
48160 Pancreatectomy, total or subtotal, with autologous transplantation of pancreas or 30-Sep-08
pancreatic islet cells
48400 Injection procedure for intraoperative pancreatography (List separately in 30-Sep-08 1
48500 Marsupialization of pancreatic cyst 30-Sep-08 1
48510 External drainage, pseudocyst of pancreas; open 30-Sep-08 1
48511 External drainage, pseudocyst of pancreas; percutaneous 30-Sep-08 1
48520 Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct 30-Sep-08 1
48540 Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y 30-Sep-08 1
48545 Pancreatorrhaphy for injury 30-Sep-08 1

48547 Duodenal exclusion with gastrojejunostomy for pancreatic injury 30-Sep-08 1
48548 Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) 30-Sep-08
48550 Donor pancreatectomy (including cold preservation), with or without duodenal 30-Sep-08 1
segment for transplantation
48551 Backbench standard preparation of cadaver donor pancreas allograft prior to 30-Sep-08 1
transplantation, including dissection of allograft from surrounding soft tissues,
splenectomy, duodenotomy, ligation of bile duct, ligation of mesenteric vessels,
and Y-graft arterial anastomoses from iliac artery to superior mesenteric artery
and to splenic artery
48552 Backbench reconstruction of cadaver donor pancreas allograft prior to 30-Sep-08 2

transplantation, venous anastomosis, each
48554 Transplantation of pancreatic allograft 30-Sep-08 1
48556 Removal of transplanted pancreatic allograft 30-Sep-08 1
48999 Unlisted procedure, pancreas 30-Sep-08
49000 Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) 30-Sep-08 1

49002 Reopening of recent laparotomy 30-Sep-08 1
49010 Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) 30-Sep-08 1
49020 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal 30-Sep-08 2

abscess; open
49021 Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal 30-Sep-08 3
abscess; percutaneous
49040 Drainage of subdiaphragmatic or subphrenic abscess; open 30-Sep-08 2
49041 Drainage of subdiaphragmatic or subphrenic abscess; percutaneous 30-Sep-08 3
49060 Drainage of retroperitoneal abscess; open 30-Sep-08 2
49061 Drainage of retroperitoneal abscess; percutaneous 30-Sep-08 3
49062 Drainage of extraperitoneal lymphocele to peritoneal cavity, open 30-Sep-08 1
49080 Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or 30-Sep-08 1
therapeutic); initial
49081 Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or 30-Sep-08 2
therapeutic); subsequent
49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle 30-Sep-08 3
49203 Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 30-Sep-08 1
1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary
tumors; largest tumor 5 cm diameter or less
tumors; largest tumor 5.1-10.0 cm diameter
tumors; largest tumor greater than 10.0 cm diameter
49215 Excision of presacral or sacrococcygeal tumor 30-Sep-08 1

49220 Staging laparotomy for Hodgkins disease or lymphoma (includes splenectomy, 30-Sep-08 1
needle or open biopsies of both liver lobes, possibly also removal of abdominal
nodes, abdominal node and/or bone marrow biopsies, ovarian repositioning)
49250 Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) 30-Sep-08 1
49255 Omentectomy, epiploectomy, resection of omentum (separate procedure) 30-Sep-08 1
49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without 30-Sep-08 1
collection of specimen(s) by brushing or washing (separate procedure)
49321 Laparoscopy, surgical; with biopsy (single or multiple) 30-Sep-08 1

49322 Laparoscopy, surgical; with aspiration of cavity or cyst (eg, ovarian cyst) (single 30-Sep-08 1
or multiple)
49323 Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity 30-Sep-08 1
49324 Laparoscopy, surgical; with insertion of tunneled intraperitoneal catheter 30-Sep-08 1
49325 Laparoscopy, surgical; with revision of previously placed intraperitoneal cannula 30-Sep-08 1
or catheter, with removal of intraluminal obstructive material if performed
49326 Laparoscopy, surgical; with omentopexy (omental tacking procedure) (List 30-Sep-08 1
49327 Laparoscopy, surgical; with placement of interstitial device(s) for radiation 15-Oct-12 1
therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic,
and/or retroperitoneum, including imaging guidance, if performed, single or
multiple (List separately in addition to code for primary procedure)
49329 Unlisted laparoscopy procedure, abdomen, peritoneum and omentum 30-Sep-08
49400 Injection of air or contrast into peritoneal cavity (separate procedure) 30-Sep-08 1
49402 Removal of peritoneal foreign body from peritoneal cavity 30-Sep-08 1
49411 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial 15-Oct-12
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 15-Oct-12 1
markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum,
including image guidance, if performed, single or multiple (List separately in
49418 Insertion of tunneled intraperitoneal catheter (eg, dialysis, intraperitoneal 15-Oct-12 1

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 30-Sep-08 1
implantable)
49420 Insertion of intraperitoneal cannula or catheter for drainage or dialysis; 30-Sep-08 14-Oct-12
temporary
49421 Insertion of tunneled intraperitoneal catheter for dialysis, open 30-Sep-08 1
49422 Removal of tunneled intraperitoneal catheter 30-Sep-08 1
49423 Exchange of previously placed abscess or cyst drainage catheter under 30-Sep-08 3
radiological guidance (separate procedure)
49424 Contrast injection for assessment of abscess or cyst via previously placed 30-Sep-08 3
drainage catheter or tube (separate procedure)
49425 Insertion of peritoneal-venous shunt 30-Sep-08 1
49426 Revision of peritoneal-venous shunt 30-Sep-08 1
49427 Injection procedure (eg, contrast media) for evaluation of previously placed 30-Sep-08 1
peritoneal-venous shunt
49428 Ligation of peritoneal-venous shunt 30-Sep-08 1
49429 Removal of peritoneal-venous shunt 30-Sep-08 1
49435 Insertion of subcutaneous extension to intraperitoneal cannula or catheter with 30-Sep-08 1
remote chest exit site (List separately in addition to code for primary procedure)
49436 Delayed creation of exit site from embedded subcutaneous segment of 30-Sep-08 1
intraperitoneal cannula or catheter
49440 Insertion of gastrostomy tube, percutaneous, under fluoroscopic guidance 30-Sep-08 1
including contrast injection(s), image documentation and report
49441 Insertion of duodenostomy or jejunostomy tube, percutaneous, under 30-Sep-08 1

fluoroscopic guidance including contrast injection(s), image documentation and
report
49442 Insertion of cecostomy or other colonic tube, percutaneous, under fluoroscopic 30-Sep-08 1
guidance including contrast injection(s), image documentation and report
49446 Conversion of gastrostomy tube to gastro-jejunostomy tube, percutaneous, 30-Sep-08 1

under fluoroscopic guidance including contrast injection(s), image
documentation and report
49450 Replacement of gastrostomy or cecostomy (or other colonic) tube, percutaneous, 30-Sep-08 1
under fluoroscopic guidance including contrast injection(s), image
documentation and report
49451 Replacement of duodenostomy or jejunostomy tube, percutaneous, under 30-Sep-08 1
fluoroscopic guidance including contrast injection(s), image documentation and
report
49452 Replacement of gastro-jejunostomy tube, percutaneous, under fluoroscopic 30-Sep-08 1
guidance including contrast injection(s), image documentation and report
49460 Mechanical removal of obstructive material from gastrostomy, duodenostomy, 30-Sep-08 1

jejunostomy, gastro-jejunostomy, or cecostomy (or other colonic) tube, any
method, under fluoroscopic guidance including contrast injection(s), if
performed, image documentation and report
49465 Contrast injection(s) for radiological evaluation of existing gastrostomy, 30-Sep-08 1

duodenostomy, jejunostomy, gastro-jejunostomy, or cecostomy (or other
colonic) tube, from a percutaneous approach including image documentation
and report
49491 Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation 30-Sep-08 1
at birth), performed from birth up to 50 weeks postconception age, with or
without hydrocelectomy; reducible
49492 Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation 30-Sep-08 1
at birth), performed from birth up to 50 weeks postconception age, with or
without hydrocelectomy; incarcerated or strangulated
49495 Repair, initial inguinal hernia, full term infant younger than age 6 months, or 30-Sep-08 1
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 Repair, initial inguinal hernia, full term infant younger than age 6 months, or 30-Sep-08 1
preterm infant older than 50 weeks postconception age and younger than age 6
months at the time of surgery, with or without hydrocelectomy; incarcerated or
strangulated
49500 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or 30-Sep-08 1
without hydrocelectomy; reducible
49501 Repair initial inguinal hernia, age 6 months to younger than 5 years, with or 30-Sep-08 1
without hydrocelectomy; incarcerated or strangulated
49505 Repair initial inguinal hernia, age 5 years or older; reducible 30-Sep-08 1
49507 Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated 30-Sep-08 1
49520 Repair recurrent inguinal hernia, any age; reducible 30-Sep-08 1

49521 Repair recurrent inguinal hernia, any age; incarcerated or strangulated 30-Sep-08 1
49525 Repair inguinal hernia, sliding, any age 30-Sep-08 1

49540 Repair lumbar hernia 30-Sep-08 1
49550 Repair initial femoral hernia, any age; reducible 30-Sep-08 1
49553 Repair initial femoral hernia, any age; incarcerated or strangulated 30-Sep-08 1
49555 Repair recurrent femoral hernia; reducible 30-Sep-08 1
49557 Repair recurrent femoral hernia; incarcerated or strangulated 30-Sep-08 1
49560 Repair initial incisional or ventral hernia; reducible 30-Sep-08
49561 Repair initial incisional or ventral hernia; incarcerated or strangulated 30-Sep-08
49565 Repair recurrent incisional or ventral hernia; reducible 30-Sep-08 2
49566 Repair recurrent incisional or ventral hernia; incarcerated or strangulated 30-Sep-08 2
49568 Implantation of mesh or other prosthesis for open incisional or ventral hernia 30-Sep-08
repair or mesh for closure of debridement for necrotizing soft tissue infection
(List separately in addition to code for the incisional or ventral hernia repair)
49570 Repair epigastric hernia (eg, preperitoneal fat); reducible (separate procedure) 30-Sep-08 1
49572 Repair epigastric hernia (eg, preperitoneal fat); incarcerated or strangulated 30-Sep-08 1
49580 Repair umbilical hernia, younger than age 5 years; reducible 30-Sep-08 1
49582 Repair umbilical hernia, younger than age 5 years; incarcerated or strangulated 30-Sep-08 1
49585 Repair umbilical hernia, age 5 years or older; reducible 30-Sep-08 1

49587 Repair umbilical hernia, age 5 years or older; incarcerated or strangulated 30-Sep-08 1
49590 Repair spigelian hernia 30-Sep-08 1

49600 Repair of small omphalocele, with primary closure 30-Sep-08 1
49605 Repair of large omphalocele or gastroschisis; with or without prosthesis 30-Sep-08 1
49606 Repair of large omphalocele or gastroschisis; with removal of prosthesis, final 30-Sep-08 1
reduction and closure, in operating room
49610 Repair of omphalocele (Gross type operation); first stage 30-Sep-08 1
49611 Repair of omphalocele (Gross type operation); second stage 30-Sep-08 1
49650 Laparoscopy, surgical; repair initial inguinal hernia 30-Sep-08 1
49651 Laparoscopy, surgical; repair recurrent inguinal hernia 30-Sep-08 1
49652 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia 15-Oct-12 2
(includes mesh insertion, when performed); reducible
49653 Laparoscopy, surgical, repair, ventral, umbilical, spigelian or epigastric hernia 15-Oct-12 2
(includes mesh insertion, when performed); incarcerated or strangulated
49654 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when 15-Oct-12 2
performed); reducible
49655 Laparoscopy, surgical, repair, incisional hernia (includes mesh insertion, when 15-Oct-12 2
performed); incarcerated or strangulated
49656 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh 15-Oct-12 2
insertion, when performed); reducible
49657 Laparoscopy, surgical, repair, recurrent incisional hernia (includes mesh 15-Oct-12 2
insertion, when performed); incarcerated or strangulated
49659 Unlisted laparoscopy procedure, hernioplasty, herniorrhaphy, herniotomy 30-Sep-08
49900 Suture, secondary, of abdominal wall for evisceration or dehiscence 30-Sep-08 1

49904 Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall 30-Sep-08 1
defects)
49905 Omental flap, intra-abdominal (List separately in addition to code for primary 30-Sep-08 1
procedure)
49906 Free omental flap with microvascular anastomosis 30-Sep-08 1
49999 Unlisted procedure, abdomen, peritoneum and omentum 30-Sep-08
50010 Renal exploration, not necessitating other specific procedures 30-Sep-08 2

50020 Drainage of perirenal or renal abscess; open 30-Sep-08 1
50021 Drainage of perirenal or renal abscess; percutaneous 30-Sep-08 2
50040 Nephrostomy, nephrotomy with drainage 30-Sep-08 2
50045 Nephrotomy, with exploration 30-Sep-08 2
50060 Nephrolithotomy; removal of calculus 30-Sep-08 2
50065 Nephrolithotomy; secondary surgical operation for calculus 30-Sep-08 2
50070 Nephrolithotomy; complicated by congenital kidney abnormality 30-Sep-08 2
50075 Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and 30-Sep-08 2
calyces (including anatrophic pyelolithotomy)
50080 Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, 30-Sep-08 2
endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm
50081 Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, 30-Sep-08 2

endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm
50100 Transection or repositioning of aberrant renal vessels (separate procedure) 30-Sep-08 2
50120 Pyelotomy; with exploration 30-Sep-08 2

50125 Pyelotomy; with drainage, pyelostomy 30-Sep-08 2
50130 Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including 30-Sep-08 2
coagulum pyelolithotomy)
50135 Pyelotomy; complicated (eg, secondary operation, congenital kidney 30-Sep-08 2
abnormality)
50200 Renal biopsy; percutaneous, by trocar or needle 30-Sep-08 2
50205 Renal biopsy; by surgical exposure of kidney 30-Sep-08 2
50220 Nephrectomy, including partial ureterectomy, any open approach including rib 30-Sep-08 2
resection;
resection; complicated because of previous surgery on same kidney
resection; radical, with regional lymphadenectomy and/or vena caval
thrombectomy
50234 Nephrectomy with total ureterectomy and bladder cuff; through same incision 30-Sep-08 2
50236 Nephrectomy with total ureterectomy and bladder cuff; through separate incision 30-Sep-08 2
50240 Nephrectomy, partial 30-Sep-08 2

50250 Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including 30-Sep-08 1
intraoperative ultrasound guidance and monitoring, if performed
50280 Excision or unroofing of cyst(s) of kidney 30-Sep-08 2
50290 Excision of perinephric cyst 30-Sep-08 1
50300 Donor nephrectomy (including cold preservation); from cadaver donor, unilateral 30-Sep-08 1
or bilateral
50320 Donor nephrectomy (including cold preservation); open, from living donor 30-Sep-08 1
50323 Backbench standard preparation of cadaver donor renal allograft prior to 30-Sep-08 1
transplantation, including dissection and removal of perinephric fat,
diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and
preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as
necessary
50325 Backbench standard preparation of living donor renal allograft (open or 30-Sep-08 1
laparoscopic) prior to transplantation, including dissection and removal of
perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s),
ligating branches, as necessary
50327 Backbench reconstruction of cadaver or living donor renal allograft prior to 30-Sep-08 3
transplantation; venous anastomosis, each
transplantation; arterial anastomosis, each
transplantation; ureteral anastomosis, each
50340 Recipient nephrectomy (separate procedure) 30-Sep-08 1
50360 Renal allotransplantation, implantation of graft; without recipient nephrectomy 30-Sep-08 1
50365 Renal allotransplantation, implantation of graft; with recipient nephrectomy 30-Sep-08 1
50370 Removal of transplanted renal allograft 30-Sep-08 1
50380 Renal autotransplantation, reimplantation of kidney 30-Sep-08 1
50382 Removal (via snare/capture) and replacement of internally dwelling ureteral 30-Sep-08 1
stent via percutaneous approach, including radiological supervision and
interpretation
50384 Removal (via snare/capture) of internally dwelling ureteral stent via 30-Sep-08 1
percutaneous approach, including radiological supervision and interpretation
50385 Removal (via snare/capture) and replacement of internally dwelling ureteral 30-Sep-08 2
stent via transurethral approach, without use of cystoscopy, including
50386 Removal (via snare/capture) of internally dwelling ureteral stent via transurethral 30-Sep-08 2
approach, without use of cystoscopy, including radiological supervision and
interpretation
50387 Removal and replacement of externally accessible transnephric ureteral stent 30-Sep-08 1
(eg, external/internal stent) requiring fluoroscopic guidance, including
50389 Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with 30-Sep-08 2
concurrent indwelling ureteral stent)
50390 Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous 30-Sep-08 2
50391 Instillation(s) of therapeutic agent into renal pelvis and/or ureter through 30-Sep-08 2
established nephrostomy, pyelostomy or ureterostomy tube (eg,
anticarcinogenic or antifungal agent)
50392 Introduction of intracatheter or catheter into renal pelvis for drainage and/or 30-Sep-08 2
injection, percutaneous
50393 Introduction of ureteral catheter or stent into ureter through renal pelvis for 30-Sep-08 2
drainage and/or injection, percutaneous
50394 Injection procedure for pyelography (as nephrostogram, pyelostogram, 30-Sep-08 2
antegrade pyeloureterograms) through nephrostomy or pyelostomy tube, or
indwelling ureteral catheter
50395 Introduction of guide into renal pelvis and/or ureter with dilation to establish 30-Sep-08 2
nephrostomy tract, percutaneous
50396 Manometric studies through nephrostomy or pyelostomy tube, or indwelling 30-Sep-08 2
ureteral catheter
50398 Change of nephrostomy or pyelostomy tube 30-Sep-08 2
50400 Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or 30-Sep-08 2
without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or
ureteral splinting; simple
50405 Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or 30-Sep-08 2
without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or
ureteral splinting; complicated (congenital kidney abnormality, secondary
pyeloplasty, solitary kidney, calycoplasty)
50500 Nephrorrhaphy, suture of kidney wound or injury 30-Sep-08 1

50520 Closure of nephrocutaneous or pyelocutaneous fistula 30-Sep-08 1
50525 Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; 30-Sep-08 1
abdominal approach
50526 Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; 30-Sep-08 1
thoracic approach
50540 Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other 30-Sep-08 1
plastic procedure, unilateral or bilateral (1 operation)
50541 Laparoscopy, surgical; ablation of renal cysts 30-Sep-08 2
50542 Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative 30-Sep-08 2
ultrasound guidance and monitoring, when performed
50543 Laparoscopy, surgical; partial nephrectomy 30-Sep-08 2
50544 Laparoscopy, surgical; pyeloplasty 30-Sep-08 2
50545 Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia 30-Sep-08 2
and surrounding fatty tissue, removal of regional lymph nodes, and
adrenalectomy)
50546 Laparoscopy, surgical; nephrectomy, including partial ureterectomy 30-Sep-08 2
50547 Laparoscopy, surgical; donor nephrectomy (including cold preservation), from 30-Sep-08 1
living donor
50548 Laparoscopy, surgical; nephrectomy with total ureterectomy 30-Sep-08 2
50549 Unlisted laparoscopy procedure, renal 30-Sep-08
50551 Renal endoscopy through established nephrostomy or pyelostomy, with or 30-Sep-08 2

without irrigation, instillation, or ureteropyelography, exclusive of radiologic
service;
service; with ureteral catheterization, with or without dilation of ureter

service; with biopsy
service; with fulguration and/or incision, with or without biopsy

service; with removal of foreign body or calculus

service; with resection of tumor
50570 Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, 30-Sep-08 2
instillation, or ureteropyelography, exclusive of radiologic service;
instillation, or ureteropyelography, exclusive of radiologic service; with ureteral
catheterization, with or without dilation of ureter
instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
instillation, or ureteropyelography, exclusive of radiologic service; with
endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and
ureteral pelvic junction, incision of ureteral pelvic junction and insertion of
endopyelotomy stent)
fulguration and/or incision, with or without biopsy
instillation, or ureteropyelography, exclusive of radiologic service; with removal
of foreign body or calculus
50590 Lithotripsy, extracorporeal shock wave 30-Sep-08 1
50592 Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency 30-Sep-08 1
50593 Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy 30-Sep-08 2

50600 Ureterotomy with exploration or drainage (separate procedure) 30-Sep-08 2
50605 Ureterotomy for insertion of indwelling stent, all types 30-Sep-08 2
50610 Ureterolithotomy; upper one-third of ureter 30-Sep-08 2
50620 Ureterolithotomy; middle one-third of ureter 30-Sep-08 2
50630 Ureterolithotomy; lower one-third of ureter 30-Sep-08 2
50650 Ureterectomy, with bladder cuff (separate procedure) 30-Sep-08 2
50660 Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or 30-Sep-08 2
perineal approach
50684 Injection procedure for ureterography or ureteropyelography through 30-Sep-08 2
ureterostomy or indwelling ureteral catheter
50686 Manometric studies through ureterostomy or indwelling ureteral catheter 30-Sep-08 2
50688 Change of ureterostomy tube or externally accessible ureteral stent via ileal 30-Sep-08 2
conduit
50690 Injection procedure for visualization of ileal conduit and/or ureteropyelography, 30-Sep-08 2
exclusive of radiologic service
50700 Ureteroplasty, plastic operation on ureter (eg, stricture) 30-Sep-08 2
50715 Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis 30-Sep-08 1
50722 Ureterolysis for ovarian vein syndrome 30-Sep-08 2

50725 Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or 30-Sep-08 1
vena cava
50727 Revision of urinary-cutaneous anastomosis (any type urostomy); 30-Sep-08 1
50728 Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of 30-Sep-08 1
fascial defect and hernia
50740 Ureteropyelostomy, anastomosis of ureter and renal pelvis 30-Sep-08 2
50750 Ureterocalycostomy, anastomosis of ureter to renal calyx 30-Sep-08 2
50760 Ureteroureterostomy 30-Sep-08 2
50770 Transureteroureterostomy, anastomosis of ureter to contralateral ureter 30-Sep-08 1
50780 Ureteroneocystostomy; anastomosis of single ureter to bladder 30-Sep-08 1

50782 Ureteroneocystostomy; anastomosis of duplicated ureter to bladder 30-Sep-08 2
50783 Ureteroneocystostomy; with extensive ureteral tailoring 30-Sep-08 2
50785 Ureteroneocystostomy; with vesico-psoas hitch or bladder flap 30-Sep-08 1
50800 Ureteroenterostomy, direct anastomosis of ureter to intestine 30-Sep-08 1
50810 Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of 30-Sep-08 1
abdominal or perineal colostomy, including intestine anastomosis
50815 Ureterocolon conduit, including intestine anastomosis 30-Sep-08 1

50820 Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker 30-Sep-08 1
operation)
50825 Continent diversion, including intestine anastomosis using any segment of small 30-Sep-08 1
and/or large intestine (Kock pouch or Camey enterocystoplasty)
50830 Urinary undiversion (eg, taking down of ureteroileal conduit, 30-Sep-08 1

ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or
ureteroneocystostomy)
50840 Replacement of all or part of ureter by intestine segment, including intestine 30-Sep-08 1
anastomosis
50845 Cutaneous appendico-vesicostomy 30-Sep-08 1
50860 Ureterostomy, transplantation of ureter to skin 30-Sep-08 1
50900 Ureterorrhaphy, suture of ureter (separate procedure) 30-Sep-08 2
50920 Closure of ureterocutaneous fistula 30-Sep-08 2
50930 Closure of ureterovisceral fistula (including visceral repair) 30-Sep-08 2
50940 Deligation of ureter 30-Sep-08 2
50945 Laparoscopy, surgical; ureterolithotomy 30-Sep-08 2
50947 Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent 30-Sep-08 2
placement
50948 Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral 30-Sep-08 2
stent placement
50949 Unlisted laparoscopy procedure, ureter 30-Sep-08
50951 Ureteral endoscopy through established ureterostomy, with or without irrigation, 30-Sep-08 2
instillation, or ureteropyelography, exclusive of radiologic service; with ureteral
instillation, or ureteropyelography, exclusive of radiologic service; with biopsy
fulguration and/or incision, with or without biopsy
instillation, or ureteropyelography, exclusive of radiologic service; with removal
of foreign body or calculus
50970 Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, 30-Sep-08 2
or ureteropyelography, exclusive of radiologic service;
or ureteropyelography, exclusive of radiologic service; with ureteral
or ureteropyelography, exclusive of radiologic service; with biopsy
or ureteropyelography, exclusive of radiologic service; with fulguration and/or
incision, with or without biopsy
or ureteropyelography, exclusive of radiologic service; with removal of foreign
body or calculus
51020 Cystotomy or cystostomy; with fulguration and/or insertion of radioactive 30-Sep-08 1
material
51030 Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion 30-Sep-08 1
51040 Cystostomy, cystotomy with drainage 30-Sep-08 1

51045 Cystotomy, with insertion of ureteral catheter or stent (separate procedure) 30-Sep-08 2
51050 Cystolithotomy, cystotomy with removal of calculus, without vesical neck 30-Sep-08 1
resection
51060 Transvesical ureterolithotomy 30-Sep-08 2
51065 Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic 30-Sep-08 1
fragmentation of ureteral calculus
51080 Drainage of perivesical or prevesical space abscess 30-Sep-08 2
51100 Aspiration of bladder; by needle 30-Sep-08 1
51101 Aspiration of bladder; by trocar or intracatheter 30-Sep-08 1
51102 Aspiration of bladder; with insertion of suprapubic catheter 30-Sep-08 1
51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair 30-Sep-08 1
51520 Cystotomy; for simple excision of vesical neck (separate procedure) 30-Sep-08 1
51525 Cystotomy; for excision of bladder diverticulum, single or multiple (separate 30-Sep-08 1
procedure)
51530 Cystotomy; for excision of bladder tumor 30-Sep-08 1
51535 Cystotomy for excision, incision, or repair of ureterocele 30-Sep-08 1
51550 Cystectomy, partial; simple 30-Sep-08 1
51555 Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult 30-Sep-08 1
location)
51565 Cystectomy, partial, with reimplantation of ureter(s) into bladder 30-Sep-08 1
(ureteroneocystostomy)
51570 Cystectomy, complete; (separate procedure) 30-Sep-08 1
51575 Cystectomy, complete; with bilateral pelvic lymphadenectomy, including 30-Sep-08 1
external iliac, hypogastric, and obturator nodes
51580 Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous 30-Sep-08 1
transplantations;
51585 Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous 30-Sep-08 1
transplantations; with bilateral pelvic lymphadenectomy, including external iliac,
hypogastric, and obturator nodes
51590 Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including 30-Sep-08 1
intestine anastomosis;
51595 Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including 30-Sep-08 1
intestine anastomosis; with bilateral pelvic lymphadenectomy, including external
iliac, hypogastric, and obturator nodes
51596 Cystectomy, complete, with continent diversion, any open technique, using any 30-Sep-08 1
segment of small and/or large intestine to construct neobladder
51597 Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with 30-Sep-08 1
removal of bladder and ureteral transplantations, with or without hysterectomy
and/or abdominoperineal resection of rectum and colon and colostomy, or any
combination thereof
51600 Injection procedure for cystography or voiding urethrocystography 30-Sep-08 1
51605 Injection procedure and placement of chain for contrast and/or chain 30-Sep-08 1
urethrocystography
51610 Injection procedure for retrograde urethrocystography 30-Sep-08 1
51700 Bladder irrigation, simple, lavage and/or instillation 30-Sep-08 1
51701 Insertion of non-indwelling bladder catheter (eg, straight catheterization for 30-Sep-08 2
residual urine)
51702 Insertion of temporary indwelling bladder catheter; simple (eg, Foley) 30-Sep-08 2
51703 Insertion of temporary indwelling bladder catheter; complicated (eg, altered 30-Sep-08 2
anatomy, fractured catheter/balloon)
51705 Change of cystostomy tube; simple 30-Sep-08 1
51710 Change of cystostomy tube; complicated 30-Sep-08 1
51715 Endoscopic injection of implant material into the submucosal tissues of the 30-Sep-08 1
urethra and/or bladder neck
51720 Bladder instillation of anticarcinogenic agent (including retention time) 30-Sep-08 1
51725 Simple cystometrogram (CMG) (eg, spinal manometer) 30-Sep-08 1

51726 Complex cystometrogram (ie, calibrated electronic equipment); 30-Sep-08 1
51727 Complex cystometrogram (ie, calibrated electronic equipment); with urethral 15-Oct-12
pressure profile studies (ie, urethral closure pressure profile), any technique
51728 Complex cystometrogram (ie, calibrated electronic equipment); with voiding 15-Oct-12
pressure studies (ie, bladder voiding pressure), any technique
51729 Complex cystometrogram (ie, calibrated electronic equipment); with voiding 15-Oct-12
pressure studies (ie, bladder voiding pressure) and urethral pressure profile
studies (ie, urethral closure pressure profile), any technique
51736 Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) 30-Sep-08 1
51741 Complex uroflowmetry (eg, calibrated electronic equipment) 30-Sep-08 1

51772 Urethral pressure profile studies (UPP) (urethral closure pressure profile), any 30-Sep-08 14-Oct-12
technique
51784 Electromyography studies (EMG) of anal or urethral sphincter, other than needle, 30-Sep-08 1
any technique
51785 Needle electromyography studies (EMG) of anal or urethral sphincter, any 30-Sep-08 1
technique
51792 Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency 30-Sep-08 1
time)
51795 Voiding pressure studies (VP); bladder voiding pressure, any technique 30-Sep-08 14-Oct-12
51797 Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) 30-Sep-08 1
51798 Measurement of post-voiding residual urine and/or bladder capacity by 30-Sep-08 1

ultrasound, non-imaging
51800 Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical 30-Sep-08 1
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 30-Sep-08 1
51840 Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, 30-Sep-08 1
Burch); simple
51841 Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, 30-Sep-08 1
Burch); complicated (eg, secondary repair)
51845 Abdomino-vaginal vesical neck suspension, with or without endoscopic control 30-Sep-08 1
(eg, Stamey, Raz, modified Pereyra)
51860 Cystorrhaphy, suture of bladder wound, injury or rupture; simple 30-Sep-08 1
51865 Cystorrhaphy, suture of bladder wound, injury or rupture; complicated 30-Sep-08 1
51880 Closure of cystostomy (separate procedure) 30-Sep-08 1

51900 Closure of vesicovaginal fistula, abdominal approach 30-Sep-08 1
51920 Closure of vesicouterine fistula; 30-Sep-08 1
51925 Closure of vesicouterine fistula; with hysterectomy 30-Sep-08 1
51940 Closure, exstrophy of bladder 30-Sep-08 1
51960 Enterocystoplasty, including intestinal anastomosis 30-Sep-08 1
51980 Cutaneous vesicostomy 30-Sep-08 1
51990 Laparoscopy, surgical; urethral suspension for stress incontinence 30-Sep-08 1
51992 Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or 30-Sep-08 1
synthetic)
51999 Unlisted laparoscopy procedure, bladder 30-Sep-08
52000 Cystourethroscopy (separate procedure) 30-Sep-08 1

52001 Cystourethroscopy with irrigation and evacuation of multiple obstructing clots 30-Sep-08 1
52005 Cystourethroscopy, with ureteral catheterization, with or without irrigation, 30-Sep-08 2

52007 Cystourethroscopy, with ureteral catheterization, with or without irrigation, 30-Sep-08 2

instillation, or ureteropyelography, exclusive of radiologic service; with brush
biopsy of ureter and/or renal pelvis
52010 Cystourethroscopy, with ejaculatory duct catheterization, with or without 30-Sep-08 1
irrigation, instillation, or duct radiography, exclusive of radiologic service
52204 Cystourethroscopy, with biopsy(s) 30-Sep-08 1

52214 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of 30-Sep-08 1
trigone, bladder neck, prostatic fossa, urethra, or periurethral glands
52224 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or 30-Sep-08 1

treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy
52234 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) 30-Sep-08 1

and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm)

and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm)
and/or resection of; LARGE bladder tumor(s)
52250 Cystourethroscopy with insertion of radioactive substance, with or without 30-Sep-08 1
biopsy or fulguration
52260 Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or 30-Sep-08 1
conduction (spinal) anesthesia
52265 Cystourethroscopy, with dilation of bladder for interstitial cystitis; local 30-Sep-08 1
anesthesia
52270 Cystourethroscopy, with internal urethrotomy; female 30-Sep-08 1
52275 Cystourethroscopy, with internal urethrotomy; male 30-Sep-08 1
52276 Cystourethroscopy with direct vision internal urethrotomy 30-Sep-08 1
52277 Cystourethroscopy, with resection of external sphincter (sphincterotomy) 30-Sep-08 1
52281 Cystourethroscopy, with calibration and/or dilation of urethral stricture or 30-Sep-08 1

stenosis, with or without meatotomy, with or without injection procedure for
cystography, male or female
52282 Cystourethroscopy, with insertion of permanent urethral stent 30-Sep-08 1
52283 Cystourethroscopy, with steroid injection into stricture 30-Sep-08 1
52285 Cystourethroscopy for treatment of the female urethral syndrome with any or all 30-Sep-08 1
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
52290 Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral 30-Sep-08 1
52300 Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), 30-Sep-08 1
unilateral or bilateral
52301 Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), 30-Sep-08 1
52305 Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, 30-Sep-08 1
single or multiple
52310 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from 30-Sep-08 1
urethra or bladder (separate procedure); simple
52315 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from 30-Sep-08 2
urethra or bladder (separate procedure); complicated
52317 Litholapaxy: crushing or fragmentation of calculus by any means in bladder and 30-Sep-08 1
removal of fragments; simple or small (less than 2.5 cm)
52318 Litholapaxy: crushing or fragmentation of calculus by any means in bladder and 30-Sep-08 1
removal of fragments; complicated or large (over 2.5 cm)
52320 Cystourethroscopy (including ureteral catheterization); with removal of ureteral 30-Sep-08 2
calculus
52325 Cystourethroscopy (including ureteral catheterization); with fragmentation of 30-Sep-08 1
ureteral calculus (eg, ultrasonic or electro-hydraulic technique)
52327 Cystourethroscopy (including ureteral catheterization); with subureteric injection 30-Sep-08 2

of implant material
52330 Cystourethroscopy (including ureteral catheterization); with manipulation, 30-Sep-08 2
without removal of ureteral calculus
52332 Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or 30-Sep-08 1
double-J type)
52334 Cystourethroscopy with insertion of ureteral guide wire through kidney to 30-Sep-08 2
establish a percutaneous nephrostomy, retrograde
52341 Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, 30-Sep-08 2
laser, electrocautery, and incision)
52342 Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon 30-Sep-08 2
dilation, laser, electrocautery, and incision)
52343 Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, 30-Sep-08 2
laser, electrocautery, and incision)
52344 Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, 30-Sep-08 2
balloon dilation, laser, electrocautery, and incision)
52345 Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction 30-Sep-08 2
stricture (eg, balloon dilation, laser, electrocautery, and incision)
52346 Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, 30-Sep-08 2
balloon dilation, laser, electrocautery, and incision)
52351 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic 30-Sep-08 1
52352 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or 30-Sep-08 2
manipulation of calculus (ureteral catheterization is included)
52353 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy 30-Sep-08 2

(ureteral catheterization is included)
52354 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or 30-Sep-08 2
fulguration of ureteral or renal pelvic lesion
52355 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of 30-Sep-08 2
ureteral or renal pelvic tumor
52400 Cystourethroscopy with incision, fulguration, or resection of congenital posterior 30-Sep-08 1
urethral valves, or congenital obstructive hypertrophic mucosal folds
52402 Cystourethroscopy with transurethral resection or incision of ejaculatory ducts 30-Sep-08 1
52450 Transurethral incision of prostate 30-Sep-08 1

52500 Transurethral resection of bladder neck (separate procedure) 30-Sep-08 1
52601 Transurethral electrosurgical resection of prostate, including control of 30-Sep-08 1
postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy,
urethral calibration and/or dilation, and internal urethrotomy are included)
52606 Transurethral fulguration for postoperative bleeding occurring after the usual 30-Sep-08 14-Oct-12
follow-up time
52612 Transurethral resection of prostate; first stage of two-stage resection (partial 30-Sep-08 14-Oct-12
resection)
52614 Transurethral resection of prostate; second stage of two-stage resection 30-Sep-08 14-Oct-12
(resection completed)
52620 Transurethral resection; of residual obstructive tissue after 90 days postoperative 30-Sep-08 14-Oct-12
52630 Transurethral resection; residual or regrowth of obstructive prostate tissue 30-Sep-08 1

including control of postoperative bleeding, complete (vasectomy, meatotomy,
cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy
are included)
52640 Transurethral resection; of postoperative bladder neck contracture 30-Sep-08 1
52647 Laser coagulation of prostate, including control of postoperative bleeding, 30-Sep-08 1
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, 30-Sep-08 1

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 30-Sep-08 1
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 30-Sep-08 1

53000 Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra 30-Sep-08 1
53010 Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, 30-Sep-08 1

external
53020 Meatotomy, cutting of meatus (separate procedure); except infant 30-Sep-08 1
53025 Meatotomy, cutting of meatus (separate procedure); infant 30-Sep-08 1
53040 Drainage of deep periurethral abscess 30-Sep-08 1
53060 Drainage of Skene's gland abscess or cyst 30-Sep-08 1
53080 Drainage of perineal urinary extravasation; uncomplicated (separate procedure) 30-Sep-08 1
53085 Drainage of perineal urinary extravasation; complicated 30-Sep-08 1

53200 Biopsy of urethra 30-Sep-08 1
53210 Urethrectomy, total, including cystostomy; female 30-Sep-08 1
53215 Urethrectomy, total, including cystostomy; male 30-Sep-08 1
53220 Excision or fulguration of carcinoma of urethra 30-Sep-08 1
53230 Excision of urethral diverticulum (separate procedure); female 30-Sep-08 1
53235 Excision of urethral diverticulum (separate procedure); male 30-Sep-08 1
53240 Marsupialization of urethral diverticulum, male or female 30-Sep-08 1
53250 Excision of bulbourethral gland (Cowper's gland) 30-Sep-08 1
53260 Excision or fulguration; urethral polyp(s), distal urethra 30-Sep-08 1
53265 Excision or fulguration; urethral caruncle 30-Sep-08 1
53270 Excision or fulguration; Skene's glands 30-Sep-08 1
53275 Excision or fulguration; urethral prolapse 30-Sep-08 1
53400 Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen 30-Sep-08 1
type)
53405 Urethroplasty; second stage (formation of urethra), including urinary diversion 30-Sep-08 1
53410 Urethroplasty, 1-stage reconstruction of male anterior urethra 30-Sep-08 1

53415 Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of 30-Sep-08 1
prostatic or membranous urethra
53420 Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous 30-Sep-08 1
urethra; first stage
53425 Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous 30-Sep-08 1
urethra; second stage
53430 Urethroplasty, reconstruction of female urethra 30-Sep-08 1
53431 Urethroplasty with tubularization of posterior urethra and/or lower bladder for 30-Sep-08 1
incontinence (eg, Tenago, Leadbetter procedure)
53440 Sling operation for correction of male urinary incontinence (eg, fascia or 30-Sep-08 1
synthetic)
53442 Removal or revision of sling for male urinary incontinence (eg, fascia or 30-Sep-08 1
synthetic)
53444 Insertion of tandem cuff (dual cuff) 30-Sep-08 1
53445 Insertion of inflatable urethral/bladder neck sphincter, including placement of 30-Sep-08 1
pump, reservoir, and cuff
53446 Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, 30-Sep-08 1
and cuff
53447 Removal and replacement of inflatable urethral/bladder neck sphincter including 30-Sep-08 1
pump, reservoir, and cuff at the same operative session
53448 Removal and replacement of inflatable urethral/bladder neck sphincter including 30-Sep-08 1
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, 30-Sep-08 1
and cuff
53450 Urethromeatoplasty, with mucosal advancement 30-Sep-08 1
53460 Urethromeatoplasty, with partial excision of distal urethral segment (Richardson 30-Sep-08 1
type procedure)
53500 Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, 30-Sep-08 1
postsurgical obstruction, scarring)
53502 Urethrorrhaphy, suture of urethral wound or injury, female 30-Sep-08 1
53505 Urethrorrhaphy, suture of urethral wound or injury; penile 30-Sep-08 1
53510 Urethrorrhaphy, suture of urethral wound or injury; perineal 30-Sep-08 1
53515 Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous 30-Sep-08 1
53520 Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) 30-Sep-08 1
53600 Dilation of urethral stricture by passage of sound or urethral dilator, male; initial 30-Sep-08 1
53601 Dilation of urethral stricture by passage of sound or urethral dilator, male; 30-Sep-08 1
subsequent
53605 Dilation of urethral stricture or vesical neck by passage of sound or urethral 30-Sep-08 1
dilator, male, general or conduction (spinal) anesthesia
53620 Dilation of urethral stricture by passage of filiform and follower, male; initial 30-Sep-08 1
53621 Dilation of urethral stricture by passage of filiform and follower, male; 30-Sep-08 1
subsequent
53660 Dilation of female urethra including suppository and/or instillation; initial 30-Sep-08 1
53661 Dilation of female urethra including suppository and/or instillation; subsequent 30-Sep-08 1
53665 Dilation of female urethra, general or conduction (spinal) anesthesia 30-Sep-08 1

53850 Transurethral destruction of prostate tissue; by microwave thermotherapy 30-Sep-08 1
53852 Transurethral destruction of prostate tissue; by radiofrequency thermotherapy 30-Sep-08 1
53853 Transurethral destruction of prostate tissue; by water-induced thermotherapy 30-Sep-08 14-Oct-12
53855 Insertion of a temporary prostatic urethral stent, including urethral measurement 15-Oct-12
53860 Transurethral radiofrequency micro-remodeling of the female bladder neck and 15-Oct-12 1
proximal urethra for stress urinary incontinence
53899 Unlisted procedure, urinary system 30-Sep-08
54000 Slitting of prepuce, dorsal or lateral (separate procedure); newborn 30-Sep-08 1

54001 Slitting of prepuce, dorsal or lateral (separate procedure); except newborn 30-Sep-08 1
54015 Incision and drainage of penis, deep 30-Sep-08 1

54050 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum 30-Sep-08 1
contagiosum, herpetic vesicle), simple; chemical
contagiosum, herpetic vesicle), simple; electrodesiccation
contagiosum, herpetic vesicle), simple; cryosurgery
contagiosum, herpetic vesicle), simple; laser surgery
contagiosum, herpetic vesicle), simple; surgical excision
contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery,
54100 Biopsy of penis; (separate procedure) 30-Sep-08 3
54105 Biopsy of penis; deep structures 30-Sep-08 2
54110 Excision of penile plaque (Peyronie disease); 30-Sep-08 1
54111 Excision of penile plaque (Peyronie disease); with graft to 5 cm in length 30-Sep-08 1
54112 Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in 30-Sep-08 1
length
54115 Removal foreign body from deep penile tissue (eg, plastic implant) 30-Sep-08 1
54120 Amputation of penis; partial 30-Sep-08 1
54125 Amputation of penis; complete 30-Sep-08 1
54130 Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy 30-Sep-08 1
54135 Amputation of penis, radical; in continuity with bilateral pelvic 30-Sep-08 1

lymphadenectomy, including external iliac, hypogastric and obturator nodes
54150 Circumcision, using clamp or other device with regional dorsal penile or ring 30-Sep-08 1
block
54160 Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate 30-Sep-08 1
(28 days of age or less)
54161 Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 30-Sep-08 1
28 days of age
54162 Lysis or excision of penile post-circumcision adhesions 30-Sep-08 1
54163 Repair incomplete circumcision 30-Sep-08 1
54164 Frenulotomy of penis 30-Sep-08 1
54200 Injection procedure for Peyronie disease; 30-Sep-08 1
54205 Injection procedure for Peyronie disease; with surgical exposure of plaque 30-Sep-08 1
54220 Irrigation of corpora cavernosa for priapism 30-Sep-08 1

54230 Injection procedure for corpora cavernosography 30-Sep-08 1
54231 Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs 30-Sep-08 1
(eg, papaverine, phentolamine)
54235 Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, 30-Sep-08 1
phentolamine)
54240 Penile plethysmography 30-Sep-08 1
54250 Nocturnal penile tumescence and/or rigidity test 30-Sep-08 1
54300 Plastic operation of penis for straightening of chordee (eg, hypospadias), with or 30-Sep-08 1
without mobilization of urethra
54304 Plastic operation on penis for correction of chordee or for first stage hypospadias 30-Sep-08 1
repair with or without transplantation of prepuce and/or skin flaps
54308 Urethroplasty for second stage hypospadias repair (including urinary diversion); 30-Sep-08 1
less than 3 cm
54312 Urethroplasty for second stage hypospadias repair (including urinary diversion); 30-Sep-08 1
greater than 3 cm
54316 Urethroplasty for second stage hypospadias repair (including urinary diversion) 30-Sep-08 1
with free skin graft obtained from site other than genitalia
54318 Urethroplasty for third stage hypospadias repair to release penis from scrotum 30-Sep-08 1
(eg, third stage Cecil repair)
54322 1-stage distal hypospadias repair (with or without chordee or circumcision); with 30-Sep-08 1
simple meatal advancement (eg, Magpi, V-flap)
urethroplasty by local skin flaps (eg, flip-flap, prepucial flap)
urethroplasty by local skin flaps and mobilization of urethra
extensive dissection to correct chordee and urethroplasty with local skin flaps,
skin graft patch, and/or island flap
54332 1-stage proximal penile or penoscrotal hypospadias repair requiring extensive 30-Sep-08 1
dissection to correct chordee and urethroplasty by use of skin graft tube and/or
island flap
54336 1-stage perineal hypospadias repair requiring extensive dissection to correct 30-Sep-08 1
chordee and urethroplasty by use of skin graft tube and/or island flap
54340 Repair of hypospadias complications (ie, fistula, stricture, diverticula); by 30-Sep-08 1

closure, incision, or excision, simple
54344 Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring 30-Sep-08 1
mobilization of skin flaps and urethroplasty with flap or patch graft
54348 Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring 30-Sep-08 1
extensive dissection and urethroplasty with flap, patch or tubed graft (includes
urinary diversion)
54352 Repair of hypospadias cripple requiring extensive dissection and excision of 30-Sep-08 1
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 30-Sep-08 1
54380 Plastic operation on penis for epispadias distal to external sphincter; 30-Sep-08 1
54385 Plastic operation on penis for epispadias distal to external sphincter; with 30-Sep-08 1
incontinence
54390 Plastic operation on penis for epispadias distal to external sphincter; with 30-Sep-08 1
exstrophy of bladder
54400 Insertion of penile prosthesis; non-inflatable (semi-rigid) 30-Sep-08 1
54401 Insertion of penile prosthesis; inflatable (self-contained) 30-Sep-08 1
54405 Insertion of multi-component, inflatable penile prosthesis, including placement 30-Sep-08 1
of pump, cylinders, and reservoir
54406 Removal of all components of a multi-component, inflatable penile prosthesis 30-Sep-08 1
without replacement of prosthesis
54408 Repair of component(s) of a multi-component, inflatable penile prosthesis 30-Sep-08 1
54410 Removal and replacement of all component(s) of a multi-component, inflatable 30-Sep-08 1

penile prosthesis at the same operative session
54411 Removal and replacement of all components of a multi-component inflatable 30-Sep-08 1
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 30-Sep-08 1

prosthesis, without replacement of prosthesis
54416 Removal and replacement of non-inflatable (semi-rigid) or inflatable (self- 30-Sep-08 1
contained) penile prosthesis at the same operative session
54417 Removal and replacement of non-inflatable (semi-rigid) or inflatable (self- 30-Sep-08 1
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 30-Sep-08 1

bilateral
54430 Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or 30-Sep-08 1
bilateral
54435 Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter 30-Sep-08 1
procedure, rongeur, or punch) for priapism
54440 Plastic operation of penis for injury 30-Sep-08 1
54450 Foreskin manipulation including lysis of preputial adhesions and stretching 30-Sep-08 1
54500 Biopsy of testis, needle (separate procedure) 30-Sep-08 2

54505 Biopsy of testis, incisional (separate procedure) 30-Sep-08 1
54512 Excision of extraparenchymal lesion of testis 30-Sep-08 2
54520 Orchiectomy, simple (including subcapsular), with or without testicular 30-Sep-08 1
prosthesis, scrotal or inguinal approach
54522 Orchiectomy, partial 30-Sep-08 2
54530 Orchiectomy, radical, for tumor; inguinal approach 30-Sep-08 2
54535 Orchiectomy, radical, for tumor; with abdominal exploration 30-Sep-08 1
54550 Exploration for undescended testis (inguinal or scrotal area) 30-Sep-08 1
54560 Exploration for undescended testis with abdominal exploration 30-Sep-08 1
54600 Reduction of torsion of testis, surgical, with or without fixation of contralateral 30-Sep-08 2
testis
54620 Fixation of contralateral testis (separate procedure) 30-Sep-08 1
54640 Orchiopexy, inguinal approach, with or without hernia repair 30-Sep-08 1
54650 Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler- 30-Sep-08 2
Stephens)
54660 Insertion of testicular prosthesis (separate procedure) 30-Sep-08 1
54670 Suture or repair of testicular injury 30-Sep-08 2
54680 Transplantation of testis(es) to thigh (because of scrotal destruction) 30-Sep-08 1
54690 Laparoscopy, surgical; orchiectomy 30-Sep-08 2

54692 Laparoscopy, surgical; orchiopexy for intra-abdominal testis 30-Sep-08 2
54699 Unlisted laparoscopy procedure, testis 30-Sep-08
54700 Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or 30-Sep-08 2
hematoma)
54800 Biopsy of epididymis, needle 30-Sep-08 2
54830 Excision of local lesion of epididymis 30-Sep-08 2
54840 Excision of spermatocele, with or without epididymectomy 30-Sep-08 2
54860 Epididymectomy; unilateral 30-Sep-08 1
54861 Epididymectomy; bilateral 30-Sep-08 1
54865 Exploration of epididymis, with or without biopsy 30-Sep-08 1
54900 Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral 30-Sep-08 1
54901 Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral 30-Sep-08 1
55000 Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of 30-Sep-08 2
medication
55040 Excision of hydrocele; unilateral 30-Sep-08 1
55041 Excision of hydrocele; bilateral 30-Sep-08 1
55060 Repair of tunica vaginalis hydrocele (Bottle type) 30-Sep-08 2
55100 Drainage of scrotal wall abscess 30-Sep-08 2
55110 Scrotal exploration 30-Sep-08 1
55120 Removal of foreign body in scrotum 30-Sep-08 1
55150 Resection of scrotum 30-Sep-08 1
55175 Scrotoplasty; simple 30-Sep-08 1
55180 Scrotoplasty; complicated 30-Sep-08 1
55200 Vasotomy, cannulization with or without incision of vas, unilateral or bilateral 30-Sep-08 1
55250 Vasectomy, unilateral or bilateral (separate procedure), including postoperative 30-Sep-08 1
semen examination(s)
55300 Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral 30-Sep-08 1
or bilateral
55400 Vasovasostomy, vasovasorrhaphy 30-Sep-08 1
55450 Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate 30-Sep-08 1

procedure)
55500 Excision of hydrocele of spermatic cord, unilateral (separate procedure) 30-Sep-08 2
55520 Excision of lesion of spermatic cord (separate procedure) 30-Sep-08 2

55530 Excision of varicocele or ligation of spermatic veins for varicocele; (separate 30-Sep-08 2
procedure)
55535 Excision of varicocele or ligation of spermatic veins for varicocele; abdominal 30-Sep-08 2
approach
55540 Excision of varicocele or ligation of spermatic veins for varicocele; with hernia 30-Sep-08 2
repair
55550 Laparoscopy, surgical, with ligation of spermatic veins for varicocele 30-Sep-08 2
55559 Unlisted laparoscopy procedure, spermatic cord 30-Sep-08
55600 Vesiculotomy; 30-Sep-08 1

55605 Vesiculotomy; complicated 30-Sep-08 2
55650 Vesiculectomy, any approach 30-Sep-08 1
55680 Excision of Mullerian duct cyst 30-Sep-08 2
55700 Biopsy, prostate; needle or punch, single or multiple, any approach 30-Sep-08 1
55705 Biopsy, prostate; incisional, any approach 30-Sep-08 1
55706 Biopsies, prostate, needle, transperineal, stereotactic template guided saturation 15-Oct-12 1
sampling, including imaging guidance
55720 Prostatotomy, external drainage of prostatic abscess, any approach; simple 30-Sep-08 1
55725 Prostatotomy, external drainage of prostatic abscess, any approach; complicated 30-Sep-08 1
55801 Prostatectomy, perineal, subtotal (including control of postoperative bleeding, 30-Sep-08 1

vasectomy, meatotomy, urethral calibration and/or dilation, and internal
urethrotomy)
55810 Prostatectomy, perineal radical; 30-Sep-08 1
55812 Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic 30-Sep-08 1
lymphadenectomy)
55815 Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, 30-Sep-08 1
including external iliac, hypogastric and obturator nodes
55821 Prostatectomy (including control of postoperative bleeding, vasectomy, 30-Sep-08 1

meatotomy, urethral calibration and/or dilation, and internal urethrotomy);
suprapubic, subtotal, 1 or 2 stages
55831 Prostatectomy (including control of postoperative bleeding, vasectomy, 30-Sep-08 1
meatotomy, urethral calibration and/or dilation, and internal urethrotomy);
retropubic, subtotal
55840 Prostatectomy, retropubic radical, with or without nerve sparing; 30-Sep-08 1
55842 Prostatectomy, retropubic radical, with or without nerve sparing; with lymph 30-Sep-08 1
node biopsy(s) (limited pelvic lymphadenectomy)
55845 Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral 30-Sep-08 1
pelvic lymphadenectomy, including external iliac, hypogastric, and obturator
nodes
55860 Exposure of prostate, any approach, for insertion of radioactive substance; 30-Sep-08 1
55862 Exposure of prostate, any approach, for insertion of radioactive substance; with 30-Sep-08 1
lymph node biopsy(s) (limited pelvic lymphadenectomy)
55865 Exposure of prostate, any approach, for insertion of radioactive substance; with 30-Sep-08 1
bilateral pelvic lymphadenectomy, including external iliac, hypogastric and
obturator nodes
55866 Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, 30-Sep-08 1
includes robotic assistance, when performed
55870 Electroejaculation 30-Sep-08 1
55873 Cryosurgical ablation of the prostate (includes ultrasonic guidance and 30-Sep-08 1
monitoring)
55875 Transperineal placement of needles or catheters into prostate for interstitial 30-Sep-08 1
radioelement application, with or without cystoscopy
55876 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial 30-Sep-08 1
markers, dosimeter), prostate (via needle, any approach), single or multiple
55899 Unlisted procedure, male genital system 30-Sep-08
55920 Placement of needles or catheters into pelvic organs and/or genitalia (except 30-Sep-08 1
prostate) for subsequent interstitial radioelement application
55970 Intersex surgery; male to female 30-Sep-08
55980 Intersex surgery; female to male 30-Sep-08
56405 Incision and drainage of vulva or perineal abscess 30-Sep-08 2

56420 Incision and drainage of Bartholin's gland abscess 30-Sep-08 1
56440 Marsupialization of Bartholin's gland cyst 30-Sep-08 1
56441 Lysis of labial adhesions 30-Sep-08 1
56442 Hymenotomy, simple incision 30-Sep-08 1
56501 Destruction of lesion(s), vulva; simple (eg, laser surgery, electrosurgery, 30-Sep-08 1
56515 Destruction of lesion(s), vulva; extensive (eg, laser surgery, electrosurgery, 30-Sep-08 1
56605 Biopsy of vulva or perineum (separate procedure); 1 lesion 30-Sep-08 1
56606 Biopsy of vulva or perineum (separate procedure); each separate additional 30-Sep-08
lesion (List separately in addition to code for primary procedure)
56620 Vulvectomy simple; partial 30-Sep-08 1

56625 Vulvectomy simple; complete 30-Sep-08 1
56630 Vulvectomy, radical, partial; 30-Sep-08 1
56631 Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy 30-Sep-08 1
56632 Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy 30-Sep-08 1
56633 Vulvectomy, radical, complete; 30-Sep-08 1

56634 Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy 30-Sep-08 1
56637 Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy 30-Sep-08 1

56640 Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic 30-Sep-08 1
lymphadenectomy
56700 Partial hymenectomy or revision of hymenal ring 30-Sep-08 1
56740 Excision of Bartholin's gland or cyst 30-Sep-08 2
56800 Plastic repair of introitus 30-Sep-08 1
56805 Clitoroplasty for intersex state 30-Sep-08 1
56810 Perineoplasty, repair of perineum, nonobstetrical (separate procedure) 30-Sep-08 1
56820 Colposcopy of the vulva; 30-Sep-08 1

56821 Colposcopy of the vulva; with biopsy(s) 30-Sep-08 1
57000 Colpotomy; with exploration 30-Sep-08 1
57010 Colpotomy; with drainage of pelvic abscess 30-Sep-08 1
57020 Colpocentesis (separate procedure) 30-Sep-08 1
57022 Incision and drainage of vaginal hematoma; obstetrical/postpartum 30-Sep-08 2
57023 Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, 30-Sep-08 2
spontaneous bleeding)
57061 Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, 30-Sep-08 1
57065 Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, 30-Sep-08 1
57100 Biopsy of vaginal mucosa; simple (separate procedure) 30-Sep-08 3
57105 Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) 30-Sep-08 2
57106 Vaginectomy, partial removal of vaginal wall; 30-Sep-08 1

57107 Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue 30-Sep-08 1
(radical vaginectomy)
57109 Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue 30-Sep-08 1
(radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-
aortic lymph node sampling (biopsy)
57110 Vaginectomy, complete removal of vaginal wall; 30-Sep-08 1
57111 Vaginectomy, complete removal of vaginal wall; with removal of paravaginal 30-Sep-08 1
tissue (radical vaginectomy)
57112 Vaginectomy, complete removal of vaginal wall; with removal of paravaginal 30-Sep-08 1
tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and
para-aortic lymph node sampling (biopsy)
57120 Colpocleisis (Le Fort type) 30-Sep-08 1
57130 Excision of vaginal septum 30-Sep-08 1
57135 Excision of vaginal cyst or tumor 30-Sep-08 2
57150 Irrigation of vagina and/or application of medicament for treatment of bacterial, 30-Sep-08 1
parasitic, or fungoid disease
57155 Insertion of uterine tandem and/or vaginal ovoids for clinical brachytherapy 30-Sep-08 1
57156 Insertion of a vaginal radiation afterloading apparatus for clinical brachytherapy 15-Oct-12 1
57160 Fitting and insertion of pessary or other intravaginal support device 30-Sep-08 1
57170 Diaphragm or cervical cap fitting with instructions 30-Sep-08 1
57180 Introduction of any hemostatic agent or pack for spontaneous or traumatic 30-Sep-08 1
nonobstetrical vaginal hemorrhage (separate procedure)
57200 Colporrhaphy, suture of injury of vagina (nonobstetrical) 30-Sep-08 1
57210 Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) 30-Sep-08 1
57220 Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral 30-Sep-08 1
plication)
57230 Plastic repair of urethrocele 30-Sep-08 1
57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele 30-Sep-08 1
57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy 30-Sep-08 1
57260 Combined anteroposterior colporrhaphy; 30-Sep-08 1

57265 Combined anteroposterior colporrhaphy; with enterocele repair 30-Sep-08 1
57267 Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site 30-Sep-08 3
(anterior, posterior compartment), vaginal approach (List separately in addition
57268 Repair of enterocele, vaginal approach (separate procedure) 30-Sep-08 1
57270 Repair of enterocele, abdominal approach (separate procedure) 30-Sep-08 1
57280 Colpopexy, abdominal approach 30-Sep-08 1
57282 Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) 30-Sep-08 1
57283 Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) 30-Sep-08 1
57284 Paravaginal defect repair (including repair of cystocele, if performed); open 30-Sep-08 1
abdominal approach
57285 Paravaginal defect repair (including repair of cystocele, if performed); vaginal 30-Sep-08 1
approach
57287 Removal or revision of sling for stress incontinence (eg, fascia or synthetic) 30-Sep-08 1
57288 Sling operation for stress incontinence (eg, fascia or synthetic) 30-Sep-08 1
57289 Pereyra procedure, including anterior colporrhaphy 30-Sep-08 1
57291 Construction of artificial vagina; without graft 30-Sep-08 1
57292 Construction of artificial vagina; with graft 30-Sep-08 1
57295 Revision (including removal) of prosthetic vaginal graft; vaginal approach 30-Sep-08 1
57296 Revision (including removal) of prosthetic vaginal graft; open abdominal 30-Sep-08 1
approach
57300 Closure of rectovaginal fistula; vaginal or transanal approach 30-Sep-08 1
57305 Closure of rectovaginal fistula; abdominal approach 30-Sep-08 1
57307 Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy 30-Sep-08 1
57308 Closure of rectovaginal fistula; transperineal approach, with perineal body 30-Sep-08 1
reconstruction, with or without levator plication
57310 Closure of urethrovaginal fistula; 30-Sep-08 1
57311 Closure of urethrovaginal fistula; with bulbocavernosus transplant 30-Sep-08 1
57320 Closure of vesicovaginal fistula; vaginal approach 30-Sep-08 1
57330 Closure of vesicovaginal fistula; transvesical and vaginal approach 30-Sep-08 1
57335 Vaginoplasty for intersex state 30-Sep-08 1
57400 Dilation of vagina under anesthesia (other than local) 30-Sep-08 1
57410 Pelvic examination under anesthesia (other than local) 30-Sep-08 1
57415 Removal of impacted vaginal foreign body (separate procedure) under 30-Sep-08 1
anesthesia (other than local)
57420 Colposcopy of the entire vagina, with cervix if present; 30-Sep-08 1
57421 Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of 30-Sep-08 1
vagina/cervix
57423 Paravaginal defect repair (including repair of cystocele, if performed), 30-Sep-08 1
laparoscopic approach
57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex) 30-Sep-08 1
57426 Revision (including removal) of prosthetic vaginal graft, laparoscopic approach 15-Oct-12
57452 Colposcopy of the cervix including upper/adjacent vagina; 30-Sep-08 1

57454 Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the 30-Sep-08 1
cervix and endocervical curettage
57455 Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the 30-Sep-08 1
cervix
57456 Colposcopy of the cervix including upper/adjacent vagina; with endocervical 30-Sep-08 1
curettage
57460 Colposcopy of the cervix including upper/adjacent vagina; with loop electrode 30-Sep-08 1
biopsy(s) of the cervix
57461 Colposcopy of the cervix including upper/adjacent vagina; with loop electrode 30-Sep-08 1
conization of the cervix
57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without 30-Sep-08 1
fulguration (separate procedure)
57505 Endocervical curettage (not done as part of a dilation and curettage) 30-Sep-08 1
57510 Cautery of cervix; electro or thermal 30-Sep-08 1
57511 Cautery of cervix; cryocautery, initial or repeat 30-Sep-08 1
57513 Cautery of cervix; laser ablation 30-Sep-08 1
57520 Conization of cervix, with or without fulguration, with or without dilation and 30-Sep-08 1
curettage, with or without repair; cold knife or laser
57522 Conization of cervix, with or without fulguration, with or without dilation and 30-Sep-08 1
curettage, with or without repair; loop electrode excision
57530 Trachelectomy (cervicectomy), amputation of cervix (separate procedure) 30-Sep-08 1
57531 Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para- 30-Sep-08 1
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; 30-Sep-08 1
57545 Excision of cervical stump, abdominal approach; with pelvic floor repair 30-Sep-08 1
57550 Excision of cervical stump, vaginal approach; 30-Sep-08 1

57555 Excision of cervical stump, vaginal approach; with anterior and/or posterior 30-Sep-08 1
repair
57556 Excision of cervical stump, vaginal approach; with repair of enterocele 30-Sep-08 1
57558 Dilation and curettage of cervical stump 30-Sep-08 1
57700 Cerclage of uterine cervix, nonobstetrical 30-Sep-08 1
57720 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach 30-Sep-08 1
57800 Dilation of cervical canal, instrumental (separate procedure) 30-Sep-08 1
58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), 30-Sep-08 1
without cervical dilation, any method (separate procedure)
58110 Endometrial sampling (biopsy) performed in conjunction with colposcopy (List 30-Sep-08 1
58120 Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) 30-Sep-08 1
58140 Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) 30-Sep-08 1
with total weight of 250 g or less and/or removal of surface myomas; abdominal
approach
58145 Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) 30-Sep-08 1
with total weight of 250 g or less and/or removal of surface myomas; vaginal
approach
58146 Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural 30-Sep-08 1
myomas and/or intramural myomas with total weight greater than 250 g,
abdominal approach
58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of 30-Sep-08 1
tube(s), with or without removal of ovary(s);
58152 Total abdominal hysterectomy (corpus and cervix), with or without removal of 30-Sep-08 1
tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg,
Marshall-Marchetti-Krantz, Burch)
58180 Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without 30-Sep-08 1
removal of tube(s), with or without removal of ovary(s)
58200 Total abdominal hysterectomy, including partial vaginectomy, with para-aortic 30-Sep-08 1
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 30-Sep-08 1
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 30-Sep-08 1
hysterectomy or cervicectomy, with or without removal of tube(s), with or
without removal of ovary(s), with removal of bladder and ureteral
transplantations, and/or abdominoperineal resection of rectum and colon and
colostomy, or any combination thereof
58260 Vaginal hysterectomy, for uterus 250 g or less; 30-Sep-08 1

58262 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or 30-Sep-08 1
ovary(s)
58263 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or 30-Sep-08 1
ovary(s), with repair of enterocele
58267 Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy 30-Sep-08 1
(Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control
58270 Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele 30-Sep-08 1
58275 Vaginal hysterectomy, with total or partial vaginectomy; 30-Sep-08 1

58280 Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele 30-Sep-08 1
58285 Vaginal hysterectomy, radical (Schauta type operation) 30-Sep-08 1

58290 Vaginal hysterectomy, for uterus greater than 250 g; 30-Sep-08 1
58291 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) 30-Sep-08 1
and/or ovary(s)
58292 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) 30-Sep-08 1
and/or ovary(s), with repair of enterocele
58293 Vaginal hysterectomy, for uterus greater than 250 g; with colpo- 30-Sep-08 1
urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without
endoscopic control
58294 Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele 30-Sep-08 1
58300 Insertion of intrauterine device (IUD) 30-Sep-08
58301 Removal of intrauterine device (IUD) 30-Sep-08 1
58321 Artificial insemination; intra-cervical 30-Sep-08 1
58322 Artificial insemination; intra-uterine 30-Sep-08 1
58323 Sperm washing for artificial insemination 30-Sep-08 1
58340 Catheterization and introduction of saline or contrast material for saline infusion 30-Sep-08 1
sonohysterography (SIS) or hysterosalpingography
58345 Transcervical introduction of fallopian tube catheter for diagnosis and/or re- 30-Sep-08 2
establishing patency (any method), with or without hysterosalpingography
58346 Insertion of Heyman capsules for clinical brachytherapy 30-Sep-08 1

58350 Chromotubation of oviduct, including materials 30-Sep-08 2
58353 Endometrial ablation, thermal, without hysteroscopic guidance 30-Sep-08 1
58356 Endometrial cryoablation with ultrasonic guidance, including endometrial 30-Sep-08 1
curettage, when performed
58400 Uterine suspension, with or without shortening of round ligaments, with or 30-Sep-08 1
without shortening of sacrouterine ligaments; (separate procedure)
58410 Uterine suspension, with or without shortening of round ligaments, with or 30-Sep-08 1
without shortening of sacrouterine ligaments; with presacral sympathectomy
58520 Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) 30-Sep-08 1

58540 Hysteroplasty, repair of uterine anomaly (Strassman type) 30-Sep-08 1
58541 Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; 30-Sep-08 1
58542 Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with 30-Sep-08 1
removal of tube(s) and/or ovary(s)
58543 Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 30-Sep-08 1
g;
58544 Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 30-Sep-08 1
g; with removal of tube(s) and/or ovary(s)
58545 Laparoscopy, surgical, myomectomy, excision; 1 to 4 intramural myomas with 30-Sep-08 1
total weight of 250 g or less and/or removal of surface myomas
58546 Laparoscopy, surgical, myomectomy, excision; 5 or more intramural myomas 30-Sep-08 1

and/or intramural myomas with total weight greater than 250 g
58548 Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic 30-Sep-08 1
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 g or less; 30-Sep-08 1
58552 Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with 30-Sep-08 1
58553 Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; 30-Sep-08 1
58554 Laparoscopy, surgical, with vaginal hysterectomy, for uterus greater than 250 g; 30-Sep-08 1
with removal of tube(s) and/or ovary(s)
58555 Hysteroscopy, diagnostic (separate procedure) 30-Sep-08 1
58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or 30-Sep-08 1
polypectomy, with or without D & C
58559 Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) 30-Sep-08 1
58560 Hysteroscopy, surgical; with division or resection of intrauterine septum (any 30-Sep-08 1
method)
58561 Hysteroscopy, surgical; with removal of leiomyomata 30-Sep-08 1
58562 Hysteroscopy, surgical; with removal of impacted foreign body 30-Sep-08 1
58563 Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, 30-Sep-08 1
electrosurgical ablation, thermoablation)
58565 Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce 30-Sep-08 1
occlusion by placement of permanent implants
58570 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; 30-Sep-08 1
58571 Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with 30-Sep-08 1
58572 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; 30-Sep-08 1
58573 Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; 30-Sep-08 1
with removal of tube(s) and/or ovary(s)
58578 Unlisted laparoscopy procedure, uterus 30-Sep-08
58579 Unlisted hysteroscopy procedure, uterus 30-Sep-08
58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, 30-Sep-08 1

58605 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, 30-Sep-08 1
postpartum, unilateral or bilateral, during same hospitalization (separate
procedure)
58611 Ligation or transection of fallopian tube(s) when done at the time of cesarean 30-Sep-08 1
delivery or intra-abdominal surgery (not a separate procedure) (List separately
58615 Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or 30-Sep-08 1
suprapubic approach
58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) 30-Sep-08 1
58661 Laparoscopy, surgical; with removal of adnexal structures (partial or total 30-Sep-08 1
oophorectomy and/or salpingectomy)
58662 Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic 30-Sep-08 1
viscera, or peritoneal surface by any method
58670 Laparoscopy, surgical; with fulguration of oviducts (with or without transection) 30-Sep-08 1
58671 Laparoscopy, surgical; with occlusion of oviducts by device (eg, band, clip, or 30-Sep-08 1
Falope ring)
58672 Laparoscopy, surgical; with fimbrioplasty 30-Sep-08 1
58673 Laparoscopy, surgical; with salpingostomy (salpingoneostomy) 30-Sep-08 1
58679 Unlisted laparoscopy procedure, oviduct, ovary 30-Sep-08
58700 Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) 30-Sep-08 1
58720 Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate 30-Sep-08 1

procedure)
58740 Lysis of adhesions (salpingolysis, ovariolysis) 30-Sep-08 1
58750 Tubotubal anastomosis 30-Sep-08 2
58752 Tubouterine implantation 30-Sep-08 2
58760 Fimbrioplasty 30-Sep-08 2
58770 Salpingostomy (salpingoneostomy) 30-Sep-08 2
58800 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal 30-Sep-08 1
approach
58805 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); 30-Sep-08 1
abdominal approach
58820 Drainage of ovarian abscess; vaginal approach, open 30-Sep-08 2
58822 Drainage of ovarian abscess; abdominal approach 30-Sep-08 2
58823 Drainage of pelvic abscess, transvaginal or transrectal approach, percutaneous 30-Sep-08 2
(eg, ovarian, pericolic)
58825 Transposition, ovary(s) 30-Sep-08 1
58900 Biopsy of ovary, unilateral or bilateral (separate procedure) 30-Sep-08 1
58920 Wedge resection or bisection of ovary, unilateral or bilateral 30-Sep-08 1
58925 Ovarian cystectomy, unilateral or bilateral 30-Sep-08 1
58940 Oophorectomy, partial or total, unilateral or bilateral; 30-Sep-08 1

58943 Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or 30-Sep-08 1
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 30-Sep-08 1
bilateral salpingo-oophorectomy and omentectomy;
bilateral salpingo-oophorectomy and omentectomy; with total abdominal
hysterectomy, pelvic and limited para-aortic lymphadenectomy
bilateral salpingo-oophorectomy and omentectomy; with radical dissection for
debulking (ie, radical excision or destruction, intra-abdominal or retroperitoneal
tumors)
58953 Bilateral salpingo-oophorectomy with omentectomy, total abdominal 30-Sep-08 1
hysterectomy and radical dissection for debulking;
58954 Bilateral salpingo-oophorectomy with omentectomy, total abdominal 30-Sep-08 1
hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy
and limited para-aortic lymphadenectomy
58956 Bilateral salpingo-oophorectomy with total omentectomy, total abdominal 30-Sep-08 1
hysterectomy for malignancy
58957 Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, 30-Sep-08 1
uterine malignancy (intra-abdominal, retroperitoneal tumors), with
omentectomy, if performed;
58958 Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, 30-Sep-08 1
uterine malignancy (intra-abdominal, retroperitoneal tumors), with
omentectomy, if performed; with pelvic lymphadenectomy and limited para-
aortic lymphadenectomy
58960 Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal 30-Sep-08 1
malignancy (second look), with or without omentectomy, peritoneal washing,
biopsy of abdominal and pelvic peritoneum, diaphragmatic assessment with
pelvic and limited para-aortic lymphadenectomy
58970 Follicle puncture for oocyte retrieval, any method 30-Sep-08 1

58974 Embryo transfer, intrauterine 30-Sep-08 1
58976 Gamete, zygote, or embryo intrafallopian transfer, any method 30-Sep-08 2
58999 Unlisted procedure, female genital system (nonobstetrical) 30-Sep-08
59000 Amniocentesis; diagnostic 30-Sep-08
59001 Amniocentesis; therapeutic amniotic fluid reduction (includes ultrasound 30-Sep-08

guidance)
59012 Cordocentesis (intrauterine), any method 30-Sep-08
59015 Chorionic villus sampling, any method 30-Sep-08
59020 Fetal contraction stress test 30-Sep-08 1
59025 Fetal non-stress test 30-Sep-08 1
59030 Fetal scalp blood sampling 30-Sep-08
59050 Fetal monitoring during labor by consulting physician (ie, non-attending 30-Sep-08 1
physician) with written report; supervision and interpretation
59051 Fetal monitoring during labor by consulting physician (ie, non-attending 30-Sep-08 1
physician) with written report; interpretation only
59070 Transabdominal amnioinfusion, including ultrasound guidance 30-Sep-08
59072 Fetal umbilical cord occlusion, including ultrasound guidance 30-Sep-08
59074 Fetal fluid drainage (eg, vesicocentesis, thoracocentesis, paracentesis), including 30-Sep-08
ultrasound guidance
59076 Fetal shunt placement, including ultrasound guidance 30-Sep-08
59100 Hysterotomy, abdominal (eg, for hydatidiform mole, abortion) 30-Sep-08 1
59120 Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring 30-Sep-08 1
salpingectomy and/or oophorectomy, abdominal or vaginal approach
59121 Surgical treatment of ectopic pregnancy; tubal or ovarian, without 30-Sep-08 1
salpingectomy and/or oophorectomy
59130 Surgical treatment of ectopic pregnancy; abdominal pregnancy 30-Sep-08 1
59135 Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy requiring 30-Sep-08 1
total hysterectomy
59136 Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with 30-Sep-08 1
partial resection of uterus
59140 Surgical treatment of ectopic pregnancy; cervical, with evacuation 30-Sep-08 1
59150 Laparoscopic treatment of ectopic pregnancy; without salpingectomy and/or 30-Sep-08 1
oophorectomy
59151 Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or 30-Sep-08 1
oophorectomy
59160 Curettage, postpartum 30-Sep-08 1
59200 Insertion of cervical dilator (eg, laminaria, prostaglandin) (separate procedure) 30-Sep-08 1
59300 Episiotomy or vaginal repair, by other than attending physician 30-Sep-08 1

59320 Cerclage of cervix, during pregnancy; vaginal 30-Sep-08 1
59325 Cerclage of cervix, during pregnancy; abdominal 30-Sep-08 1
59350 Hysterorrhaphy of ruptured uterus 30-Sep-08 1
59400 Routine obstetric care including antepartum care, vaginal delivery (with or 30-Sep-08 1
without episiotomy, and/or forceps) and postpartum care
59409 Vaginal delivery only (with or without episiotomy and/or forceps); 30-Sep-08
59410 Vaginal delivery only (with or without episiotomy and/or forceps); including 30-Sep-08 1
postpartum care
59412 External cephalic version, with or without tocolysis 30-Sep-08 2
59414 Delivery of placenta (separate procedure) 30-Sep-08 1
59425 Antepartum care only; 4-6 visits 30-Sep-08 1
59426 Antepartum care only; 7 or more visits 30-Sep-08 1
59430 Postpartum care only (separate procedure) 30-Sep-08 1
59510 Routine obstetric care including antepartum care, cesarean delivery, and 30-Sep-08 1
postpartum care
59514 Cesarean delivery only; 30-Sep-08 1
59515 Cesarean delivery only; including postpartum care 30-Sep-08 1
59525 Subtotal or total hysterectomy after cesarean delivery (List separately in 30-Sep-08 1
59610 Routine obstetric care including antepartum care, vaginal delivery (with or 30-Sep-08 1
without episiotomy, and/or forceps) and postpartum care, after previous
cesarean delivery
59612 Vaginal delivery only, after previous cesarean delivery (with or without 30-Sep-08
episiotomy and/or forceps);
59614 Vaginal delivery only, after previous cesarean delivery (with or without 30-Sep-08 1
episiotomy and/or forceps); including postpartum care
59618 Routine obstetric care including antepartum care, cesarean delivery, and 30-Sep-08 1
postpartum care, following attempted vaginal delivery after previous cesarean
delivery
59620 Cesarean delivery only, following attempted vaginal delivery after previous 30-Sep-08 1
cesarean delivery;
59622 Cesarean delivery only, following attempted vaginal delivery after previous 30-Sep-08 1
cesarean delivery; including postpartum care
59812 Treatment of incomplete abortion, any trimester, completed surgically 30-Sep-08 1
59820 Treatment of missed abortion, completed surgically; first trimester 30-Sep-08 1

59821 Treatment of missed abortion, completed surgically; second trimester 30-Sep-08 1
59830 Treatment of septic abortion, completed surgically 30-Sep-08 1
59840 Induced abortion, by dilation and curettage 30-Sep-08 1
59841 Induced abortion, by dilation and evacuation 30-Sep-08 1
59850 Induced abortion, by 1 or more intra-amniotic injections (amniocentesis- 30-Sep-08 1
injections), including hospital admission and visits, delivery of fetus and
secundines;
secundines; with dilation and curettage and/or evacuation

secundines; with hysterotomy (failed intra-amniotic injection)
59855 Induced abortion, by 1 or more vaginal suppositories (eg, prostaglandin) with or 30-Sep-08 1
without cervical dilation (eg, laminaria), including hospital admission and visits,
delivery of fetus and secundines;
delivery of fetus and secundines; with dilation and curettage and/or evacuation
delivery of fetus and secundines; with hysterotomy (failed medical evacuation)
59866 Multifetal pregnancy reduction(s) (MPR) 30-Sep-08 1

59870 Uterine evacuation and curettage for hydatidiform mole 30-Sep-08 1
59871 Removal of cerclage suture under anesthesia (other than local) 30-Sep-08 1
59897 Unlisted fetal invasive procedure, including ultrasound guidance, when 30-Sep-08
performed
59898 Unlisted laparoscopy procedure, maternity care and delivery 30-Sep-08
59899 Unlisted procedure, maternity care and delivery 30-Sep-08
60000 Incision and drainage of thyroglossal duct cyst, infected 30-Sep-08 1

60100 Biopsy thyroid, percutaneous core needle 30-Sep-08
60200 Excision of cyst or adenoma of thyroid, or transection of isthmus 30-Sep-08 2
60210 Partial thyroid lobectomy, unilateral; with or without isthmusectomy 30-Sep-08 1
60212 Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, 30-Sep-08 1
including isthmusectomy
60220 Total thyroid lobectomy, unilateral; with or without isthmusectomy 30-Sep-08 1
60225 Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, 30-Sep-08 1
including isthmusectomy
60240 Thyroidectomy, total or complete 30-Sep-08 1
60252 Thyroidectomy, total or subtotal for malignancy; with limited neck dissection 30-Sep-08 1
60254 Thyroidectomy, total or subtotal for malignancy; with radical neck dissection 30-Sep-08 1
60260 Thyroidectomy, removal of all remaining thyroid tissue following previous 30-Sep-08 1
removal of a portion of thyroid
60270 Thyroidectomy, including substernal thyroid; sternal split or transthoracic 30-Sep-08 1
approach
60271 Thyroidectomy, including substernal thyroid; cervical approach 30-Sep-08 1
60280 Excision of thyroglossal duct cyst or sinus; 30-Sep-08 1
60281 Excision of thyroglossal duct cyst or sinus; recurrent 30-Sep-08 1
60300 Aspiration and/or injection, thyroid cyst 30-Sep-08
60500 Parathyroidectomy or exploration of parathyroid(s); 30-Sep-08 1
60502 Parathyroidectomy or exploration of parathyroid(s); re-exploration 30-Sep-08 1
60505 Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, 30-Sep-08 1
sternal split or transthoracic approach
60512 Parathyroid autotransplantation (List separately in addition to code for primary 30-Sep-08 1
procedure)
60520 Thymectomy, partial or total; transcervical approach (separate procedure) 30-Sep-08 1
60521 Thymectomy, partial or total; sternal split or transthoracic approach, without 30-Sep-08 1
radical mediastinal dissection (separate procedure)
60522 Thymectomy, partial or total; sternal split or transthoracic approach, with radical 30-Sep-08 1
mediastinal dissection (separate procedure)
60540 Adrenalectomy, partial or complete, or exploration of adrenal gland with or 30-Sep-08 1
without biopsy, transabdominal, lumbar or dorsal (separate procedure);
60545 Adrenalectomy, partial or complete, or exploration of adrenal gland with or 30-Sep-08 2

without biopsy, transabdominal, lumbar or dorsal (separate procedure); with
excision of adjacent retroperitoneal tumor
60600 Excision of carotid body tumor; without excision of carotid artery 30-Sep-08 1
60605 Excision of carotid body tumor; with excision of carotid artery 30-Sep-08 1
60650 Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of 30-Sep-08 2
adrenal gland with or without biopsy, transabdominal, lumbar or dorsal
60659 Unlisted laparoscopy procedure, endocrine system 30-Sep-08
60699 Unlisted procedure, endocrine system 30-Sep-08
61000 Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; initial 30-Sep-08 1
61001 Subdural tap through fontanelle, or suture, infant, unilateral or bilateral; 30-Sep-08 1
subsequent taps
61020 Ventricular puncture through previous burr hole, fontanelle, suture, or implanted 30-Sep-08 2
ventricular catheter/reservoir; without injection
61026 Ventricular puncture through previous burr hole, fontanelle, suture, or implanted 30-Sep-08 2
ventricular catheter/reservoir; with injection of medication or other substance for
diagnosis or treatment
61050 Cisternal or lateral cervical (C1-C2) puncture; without injection (separate 30-Sep-08 1
procedure)
61055 Cisternal or lateral cervical (C1-C2) puncture; with injection of medication or 30-Sep-08 1
other substance for diagnosis or treatment (eg, C1-C2)
61070 Puncture of shunt tubing or reservoir for aspiration or injection procedure 30-Sep-08 2
61105 Twist drill hole for subdural or ventricular puncture 30-Sep-08 2
61107 Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for 30-Sep-08 2
implanting ventricular catheter, pressure recording device, or other intracerebral
monitoring device
61108 Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for 30-Sep-08 2
evacuation and/or drainage of subdural hematoma
61120 Burr hole(s) for ventricular puncture (including injection of gas, contrast media, 30-Sep-08 1
dye, or radioactive material)
61140 Burr hole(s) or trephine; with biopsy of brain or intracranial lesion 30-Sep-08 2
61150 Burr hole(s) or trephine; with drainage of brain abscess or cyst 30-Sep-08 2
61151 Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial 30-Sep-08 2
abscess or cyst
61154 Burr hole(s) with evacuation and/or drainage of hematoma, extradural or 30-Sep-08 2
subdural
61156 Burr hole(s); with aspiration of hematoma or cyst, intracerebral 30-Sep-08 2
61210 Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), 30-Sep-08 1
pressure recording device, or other cerebral monitoring device (separate
procedure)
61215 Insertion of subcutaneous reservoir, pump or continuous infusion system for 30-Sep-08 1
connection to ventricular catheter
61250 Burr hole(s) or trephine, supratentorial, exploratory, not followed by other 30-Sep-08 1
surgery
61253 Burr hole(s) or trephine, infratentorial, unilateral or bilateral 30-Sep-08 1
61304 Craniectomy or craniotomy, exploratory; supratentorial 30-Sep-08 1
61305 Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) 30-Sep-08 1
61312 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; 30-Sep-08 2

extradural or subdural
61313 Craniectomy or craniotomy for evacuation of hematoma, supratentorial; 30-Sep-08 2
intracerebral
61314 Craniectomy or craniotomy for evacuation of hematoma, infratentorial; 30-Sep-08 2
extradural or subdural
61315 Craniectomy or craniotomy for evacuation of hematoma, infratentorial; 30-Sep-08 1
intracerebellar
61316 Incision and subcutaneous placement of cranial bone graft (List separately in 30-Sep-08 1
61320 Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial 30-Sep-08 2
61321 Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial 30-Sep-08 2
61322 Craniectomy or craniotomy, decompressive, with or without duraplasty, for 30-Sep-08 1

treatment of intracranial hypertension, without evacuation of associated
intraparenchymal hematoma; without lobectomy
61323 Craniectomy or craniotomy, decompressive, with or without duraplasty, for 30-Sep-08 1

treatment of intracranial hypertension, without evacuation of associated
intraparenchymal hematoma; with lobectomy
61330 Decompression of orbit only, transcranial approach 30-Sep-08 1

61332 Exploration of orbit (transcranial approach); with biopsy 30-Sep-08 2
61333 Exploration of orbit (transcranial approach); with removal of lesion 30-Sep-08 2
61334 Exploration of orbit (transcranial approach); with removal of foreign body 30-Sep-08 2
61340 Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle 30-Sep-08 1

syndrome)
61343 Craniectomy, suboccipital with cervical laminectomy for decompression of 30-Sep-08 1
medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari
malformation)
61345 Other cranial decompression, posterior fossa 30-Sep-08 1
61440 Craniotomy for section of tentorium cerebelli (separate procedure) 30-Sep-08 1
61450 Craniectomy, subtemporal, for section, compression, or decompression of 30-Sep-08 1
sensory root of gasserian ganglion
61458 Craniectomy, suboccipital; for exploration or decompression of cranial nerves 30-Sep-08 1
61460 Craniectomy, suboccipital; for section of 1 or more cranial nerves 30-Sep-08 1

61470 Craniectomy, suboccipital; for medullary tractotomy 30-Sep-08 1
61480 Craniectomy, suboccipital; for mesencephalic tractotomy or pedunculotomy 30-Sep-08 1
61490 Craniotomy for lobotomy, including cingulotomy 30-Sep-08 1
61500 Craniectomy; with excision of tumor or other bone lesion of skull 30-Sep-08 3
61501 Craniectomy; for osteomyelitis 30-Sep-08 1
61510 Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, 30-Sep-08
supratentorial, except meningioma
61512 Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, 30-Sep-08 3
supratentorial
61514 Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, 30-Sep-08 2
supratentorial
61516 Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of 30-Sep-08 2
cyst, supratentorial
61517 Implantation of brain intracavitary chemotherapy agent (List separately in 30-Sep-08 1
61518 Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except 30-Sep-08 2
meningioma, cerebellopontine angle tumor, or midline tumor at base of skull
61519 Craniectomy for excision of brain tumor, infratentorial or posterior fossa; 30-Sep-08 2
meningioma
61520 Craniectomy for excision of brain tumor, infratentorial or posterior fossa; 30-Sep-08 1
cerebellopontine angle tumor
61521 Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline 30-Sep-08 1
tumor at base of skull
61522 Craniectomy, infratentorial or posterior fossa; for excision of brain abscess 30-Sep-08 2
61524 Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst 30-Sep-08 2
61526 Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of 30-Sep-08 1
cerebellopontine angle tumor;
61530 Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of 30-Sep-08 1
cerebellopontine angle tumor; combined with middle/posterior fossa
craniotomy/craniectomy
61531 Subdural implantation of strip electrodes through 1 or more burr or trephine 30-Sep-08
hole(s) for long-term seizure monitoring
61533 Craniotomy with elevation of bone flap; for subdural implantation of an electrode 30-Sep-08 2
array, for long-term seizure monitoring
61534 Craniotomy with elevation of bone flap; for excision of epileptogenic focus 30-Sep-08 1
without electrocorticography during surgery
61535 Craniotomy with elevation of bone flap; for removal of epidural or subdural 30-Sep-08 2
electrode array, without excision of cerebral tissue (separate procedure)
61536 Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic 30-Sep-08 1
focus, with electrocorticography during surgery (includes removal of electrode
array)
61537 Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without 30-Sep-08 1
electrocorticography during surgery
61538 Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with 30-Sep-08 1
61539 Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, 30-Sep-08 1
partial or total, with electrocorticography during surgery
61540 Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, 30-Sep-08 1
partial or total, without electrocorticography during surgery
61541 Craniotomy with elevation of bone flap; for transection of corpus callosum 30-Sep-08 1
61542 Craniotomy with elevation of bone flap; for total hemispherectomy 30-Sep-08 1
61543 Craniotomy with elevation of bone flap; for partial or subtotal (functional) 30-Sep-08 1
hemispherectomy
61544 Craniotomy with elevation of bone flap; for excision or coagulation of choroid 30-Sep-08 2
plexus
61545 Craniotomy with elevation of bone flap; for excision of craniopharyngioma 30-Sep-08 1
61546 Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial 30-Sep-08 1

approach
61548 Hypophysectomy or excision of pituitary tumor, transnasal or transseptal 30-Sep-08 1
approach, nonstereotactic
61550 Craniectomy for craniosynostosis; single cranial suture 30-Sep-08 1
61552 Craniectomy for craniosynostosis; multiple cranial sutures 30-Sep-08 1
61556 Craniotomy for craniosynostosis; frontal or parietal bone flap 30-Sep-08 1
61557 Craniotomy for craniosynostosis; bifrontal bone flap 30-Sep-08 1
61558 Extensive craniectomy for multiple cranial suture craniosynostosis (eg, 30-Sep-08 1
cloverleaf skull); not requiring bone grafts
61559 Extensive craniectomy for multiple cranial suture craniosynostosis (eg, 30-Sep-08 1
cloverleaf skull); 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 30-Sep-08 2
dysplasia); without optic nerve decompression
61564 Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous 30-Sep-08 2
dysplasia); with optic nerve decompression
61566 Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy 30-Sep-08 1
61567 Craniotomy with elevation of bone flap; for multiple subpial transections, with 30-Sep-08 1
61570 Craniectomy or craniotomy; with excision of foreign body from brain 30-Sep-08 2
61571 Craniectomy or craniotomy; with treatment of penetrating wound of brain 30-Sep-08 2
61575 Transoral approach to skull base, brain stem or upper spinal cord for biopsy, 30-Sep-08 1
decompression or excision of lesion;
61576 Transoral approach to skull base, brain stem or upper spinal cord for biopsy, 30-Sep-08 1
decompression or excision of lesion; requiring splitting of tongue and/or
mandible (including tracheostomy)
61580 Craniofacial approach to anterior cranial fossa; extradural, including lateral 30-Sep-08 1
rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital
exenteration
61581 Craniofacial approach to anterior cranial fossa; extradural, including lateral 30-Sep-08 1
rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or
maxillectomy
61582 Craniofacial approach to anterior cranial fossa; extradural, including unilateral or 30-Sep-08 1
bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior
cranial fossa
61583 Craniofacial approach to anterior cranial fossa; intradural, including unilateral or 30-Sep-08 1
bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of
anterior cranial fossa
61584 Orbitocranial approach to anterior cranial fossa, extradural, including 30-Sep-08 1
supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s);
without orbital exenteration
61585 Orbitocranial approach to anterior cranial fossa, extradural, including 30-Sep-08 1
supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s);
with orbital exenteration
61586 Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial 30-Sep-08 1
fossa with or without internal fixation, without bone graft
61590 Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal 30-Sep-08 1

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 30-Sep-08 1
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 30-Sep-08 1
carotid artery, clivus, basilar artery or petrous apex) including osteotomy of
zygoma, craniotomy, extra- or intradural elevation of temporal lobe
61595 Transtemporal approach to posterior cranial fossa, jugular foramen or midline 30-Sep-08 1
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 30-Sep-08 1
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 30-Sep-08 1
midline skull base, including occipital condylectomy, mastoidectomy, resection
of C1-C3 vertebral body(s), decompression of vertebral artery, with or without
mobilization
61598 Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, 30-Sep-08 1
including ligation of superior petrosal sinus and/or sigmoid sinus
61600 Resection or excision of neoplastic, vascular or infectious lesion of base of 30-Sep-08 1

anterior cranial fossa; extradural
anterior cranial fossa; intradural, including dural repair, with or without graft
61605 Resection or excision of neoplastic, vascular or infectious lesion of infratemporal 30-Sep-08 1

fossa, parapharyngeal space, petrous apex; extradural
61606 Resection or excision of neoplastic, vascular or infectious lesion of infratemporal 30-Sep-08 1
fossa, parapharyngeal space, petrous apex; intradural, including dural repair,
with or without graft
61607 Resection or excision of neoplastic, vascular or infectious lesion of parasellar 30-Sep-08 1
area, cavernous sinus, clivus or midline skull base; extradural
61608 Resection or excision of neoplastic, vascular or infectious lesion of parasellar 30-Sep-08 1

area, cavernous sinus, clivus or midline skull base; intradural, including dural
repair, with or without graft
61609 Transection or ligation, carotid artery in cavernous sinus; without repair (List 30-Sep-08 1
61610 Transection or ligation, carotid artery in cavernous sinus; with repair by 30-Sep-08 1
anastomosis or graft (List separately in addition to code for primary procedure)
61611 Transection or ligation, carotid artery in petrous canal; without repair (List 30-Sep-08 1
61612 Transection or ligation, carotid artery in petrous canal; with repair by 30-Sep-08 1
anastomosis or graft (List separately in addition to code for primary procedure)
61613 Obliteration of carotid aneurysm, arteriovenous malformation, or carotid- 30-Sep-08 1

cavernous fistula by dissection within cavernous sinus
posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral
bodies; extradural
posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral
bodies; intradural, including dural repair, with or without graft
61618 Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or 30-Sep-08 2
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 Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or 30-Sep-08 2
posterior cranial fossa following surgery of the skull base; by local or
regionalized vascularized pedicle flap or myocutaneous flap (including galea,
temporalis, frontalis or occipitalis muscle)
61623 Endovascular temporary balloon arterial occlusion, head or neck 30-Sep-08 2
(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 30-Sep-08 2
achieve hemostasis, to occlude a vascular malformation), percutaneous, any
method; central nervous system (intracranial, spinal cord)
61626 Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to 30-Sep-08 2
achieve hemostasis, to occlude a vascular malformation), percutaneous, any
method; non-central nervous system, head or neck (extracranial,
brachiocephalic branch)
61630 Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous 30-Sep-08 2
61635 Transcatheter placement of intravascular stent(s), intracranial (eg, 30-Sep-08 2

atherosclerotic stenosis), including balloon angioplasty, if performed
61640 Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel 30-Sep-08
61641 Balloon dilatation of intracranial vasospasm, percutaneous; each additional 30-Sep-08

vessel in same vascular family (List separately in addition to code for primary
procedure)
61642 Balloon dilatation of intracranial vasospasm, percutaneous; each additional 30-Sep-08
vessel in different vascular family (List separately in addition to code for primary
procedure)
61680 Surgery of intracranial arteriovenous malformation; supratentorial, simple 30-Sep-08 1
61682 Surgery of intracranial arteriovenous malformation; supratentorial, complex 30-Sep-08 1
61684 Surgery of intracranial arteriovenous malformation; infratentorial, simple 30-Sep-08 1
61686 Surgery of intracranial arteriovenous malformation; infratentorial, complex 30-Sep-08 1
61690 Surgery of intracranial arteriovenous malformation; dural, simple 30-Sep-08 1

61692 Surgery of intracranial arteriovenous malformation; dural, complex 30-Sep-08 1
61697 Surgery of complex intracranial aneurysm, intracranial approach; carotid 30-Sep-08 3
circulation
61698 Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar 30-Sep-08 2
circulation
61700 Surgery of simple intracranial aneurysm, intracranial approach; carotid 30-Sep-08 3
circulation
61702 Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar 30-Sep-08 2
circulation
61703 Surgery of intracranial aneurysm, cervical approach by application of occluding 30-Sep-08 1
clamp to cervical carotid artery (Selverstone-Crutchfield type)
61705 Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by 30-Sep-08 1

intracranial and cervical occlusion of carotid artery
intracranial electrothrombosis
intra-arterial embolization, injection procedure, or balloon catheter
61711 Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) 30-Sep-08 1

arteries
61720 Creation of lesion by stereotactic method, including burr hole(s) and localizing 30-Sep-08 2
and recording techniques, single or multiple stages; globus pallidus or thalamus
61735 Creation of lesion by stereotactic method, including burr hole(s) and localizing 30-Sep-08 2
and recording techniques, single or multiple stages; subcortical structure(s)
other than globus pallidus or thalamus
61750 Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial 30-Sep-08 2
lesion;
61751 Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial 30-Sep-08 3
lesion; with computed tomography and/or magnetic resonance guidance
61760 Stereotactic implantation of depth electrodes into the cerebrum for long-term 30-Sep-08 1
seizure monitoring
61770 Stereotactic localization, including burr hole(s), with insertion of catheter(s) or 30-Sep-08 1
probe(s) for placement of radiation source
61781 Stereotactic computer-assisted (navigational) procedure; cranial, intradural (List 15-Oct-12 1
61782 Stereotactic computer-assisted (navigational) procedure; cranial, extradural (List 15-Oct-12 1
61783 Stereotactic computer-assisted (navigational) procedure; spinal (List separately 15-Oct-12 1
61790 Creation of lesion by stereotactic method, percutaneous, by neurolytic agent 30-Sep-08 2
(eg, alcohol, thermal, electrical, radiofrequency); gasserian ganglion
61791 Creation of lesion by stereotactic method, percutaneous, by neurolytic agent 30-Sep-08 2

(eg, alcohol, thermal, electrical, radiofrequency); trigeminal medullary tract
61793 Stereotactic radiosurgery (particle beam, gamma ray or linear accelerator), one 30-Sep-08 14-Oct-12
or more sessions
61795 Stereotactic computer-assisted volumetric (navigational) procedure, intracranial, 30-Sep-08 14-Oct-12
extracranial, or spinal (List separately in addition to code for primary procedure)
61796 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 1 15-Oct-12 1
simple cranial lesion
61797 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 15-Oct-12
each additional cranial lesion, simple (List separately in addition to code for
primary procedure)
complex cranial lesion
61799 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 15-Oct-12
each additional cranial lesion, complex (List separately in addition to code for
primary procedure)
61800 Application of stereotactic headframe for stereotactic radiosurgery (List 15-Oct-12 1
61850 Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical 30-Sep-08 1
61860 Craniectomy or craniotomy for implantation of neurostimulator electrodes, 30-Sep-08 1

cerebral, cortical
61863 Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation 30-Sep-08 2
of neurostimulator electrode array in subcortical site (eg, thalamus, globus
pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use
of intraoperative microelectrode recording; first array
pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without use
of intraoperative microelectrode recording; each additional array (List separately
in addition to primary procedure)
pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of
intraoperative microelectrode recording; first array
pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of
intraoperative microelectrode recording; each additional array (List separately in
61870 Craniectomy for implantation of neurostimulator electrodes, cerebellar; cortical 30-Sep-08 1
61875 Craniectomy for implantation of neurostimulator electrodes, cerebellar; 30-Sep-08 1

subcortical
61880 Revision or removal of intracranial neurostimulator electrodes 30-Sep-08 1
61885 Insertion or replacement of cranial neurostimulator pulse generator or receiver, 30-Sep-08 2
direct or inductive coupling; with connection to a single electrode array
61886 Insertion or replacement of cranial neurostimulator pulse generator or receiver, 30-Sep-08 1

direct or inductive coupling; with connection to 2 or more electrode arrays
61888 Revision or removal of cranial neurostimulator pulse generator or receiver 30-Sep-08 2
62000 Elevation of depressed skull fracture; simple, extradural 30-Sep-08 1

62005 Elevation of depressed skull fracture; compound or comminuted, extradural 30-Sep-08 1
62010 Elevation of depressed skull fracture; with repair of dura and/or debridement of 30-Sep-08 1
brain
62100 Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for 30-Sep-08 1
rhinorrhea/otorrhea
62115 Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring bone 30-Sep-08 1
grafts or cranioplasty
62116 Reduction of craniomegalic skull (eg, treated hydrocephalus); with simple 30-Sep-08 1
cranioplasty
62117 Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring 30-Sep-08 1
craniotomy and reconstruction with or without bone graft (includes obtaining
grafts)
62120 Repair of encephalocele, skull vault, including cranioplasty 30-Sep-08 1
62121 Craniotomy for repair of encephalocele, skull base 30-Sep-08 1
62140 Cranioplasty for skull defect; up to 5 cm diameter 30-Sep-08 1
62141 Cranioplasty for skull defect; larger than 5 cm diameter 30-Sep-08 1
62142 Removal of bone flap or prosthetic plate of skull 30-Sep-08 2
62143 Replacement of bone flap or prosthetic plate of skull 30-Sep-08 2
62145 Cranioplasty for skull defect with reparative brain surgery 30-Sep-08 2
62146 Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter 30-Sep-08 2
62147 Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm 30-Sep-08 2
diameter
62148 Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List 30-Sep-08 2
62160 Neuroendoscopy, intracranial, for placement or replacement of ventricular 30-Sep-08 1

catheter and attachment to shunt system or external drainage (List separately in
62161 Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of 30-Sep-08 1
septum pellucidum or intraventricular cysts (including placement, replacement,
or removal of ventricular catheter)
62162 Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, 30-Sep-08 1
including placement of external ventricular catheter for drainage
62163 Neuroendoscopy, intracranial; with retrieval of foreign body 30-Sep-08 1
62164 Neuroendoscopy, intracranial; with excision of brain tumor, including placement 30-Sep-08 1
of external ventricular catheter for drainage
62165 Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or 30-Sep-08 1
trans-sphenoidal approach
62180 Ventriculocisternostomy (Torkildsen type operation) 30-Sep-08 1
62190 Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular 30-Sep-08 1
62192 Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus 30-Sep-08 1
62194 Replacement or irrigation, subarachnoid/subdural catheter 30-Sep-08 2

62200 Ventriculocisternostomy, third ventricle; 30-Sep-08 1
62201 Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method 30-Sep-08 1
62220 Creation of shunt; ventriculo-atrial, -jugular, -auricular 30-Sep-08 1

62223 Creation of shunt; ventriculo-peritoneal, -pleural, other terminus 30-Sep-08 1
62225 Replacement or irrigation, ventricular catheter 30-Sep-08 2
62230 Replacement or revision of cerebrospinal fluid shunt, obstructed valve, or distal 30-Sep-08 2
catheter in shunt system
62252 Reprogramming of programmable cerebrospinal shunt 30-Sep-08 2
62256 Removal of complete cerebrospinal fluid shunt system; without replacement 30-Sep-08 1
62258 Removal of complete cerebrospinal fluid shunt system; with replacement by 30-Sep-08 1
similar or other shunt at same operation
62263 Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic 30-Sep-08 1
saline, enzyme) or mechanical means (eg, catheter) including radiologic
localization (includes contrast when administered), multiple adhesiolysis
sessions; 2 or more days
62264 Percutaneous lysis of epidural adhesions using solution injection (eg, hypertonic 30-Sep-08 1
saline, enzyme) or mechanical means (eg, catheter) including radiologic
localization (includes contrast when administered), multiple adhesiolysis
sessions; 1 day
62267 Percutaneous aspiration within the nucleus pulposus, intervertebral disc, or 15-Oct-12 2
paravertebral tissue for diagnostic purposes
62268 Percutaneous aspiration, spinal cord cyst or syrinx 30-Sep-08 1
62269 Biopsy of spinal cord, percutaneous needle 30-Sep-08 2
62270 Spinal puncture, lumbar, diagnostic 30-Sep-08 2
62272 Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or 30-Sep-08 1
catheter)
62273 Injection, epidural, of blood or clot patch 30-Sep-08 2
62280 Injection/infusion of neurolytic substance (eg, alcohol, phenol, iced saline 30-Sep-08 1
solutions), with or without other therapeutic substance; subarachnoid
solutions), with or without other therapeutic substance; epidural, cervical or
thoracic
solutions), with or without other therapeutic substance; epidural, lumbar, sacral
(caudal)
62284 Injection procedure for myelography and/or computed tomography, spinal (other 30-Sep-08 1
than C1-C2 and posterior fossa)
62287 Decompression procedure, percutaneous, of nucleus pulposus of intervertebral 30-Sep-08 1
disc, any method, single or multiple levels, lumbar (eg, manual or automated
percutaneous discectomy, percutaneous laser discectomy)
62290 Injection procedure for discography, each level; lumbar 30-Sep-08

62291 Injection procedure for discography, each level; cervical or thoracic 30-Sep-08
62292 Injection procedure for chemonucleolysis, including discography, intervertebral 30-Sep-08 1
disc, single or multiple levels, lumbar
62294 Injection procedure, arterial, for occlusion of arteriovenous malformation, spinal 30-Sep-08 2
62310 Injection, single (not via indwelling catheter), not including neurolytic 30-Sep-08 1
substances, with or without contrast (for either localization or epidurography), of
diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic,
opioid, steroid, other solution), epidural or subarachnoid; cervical or thoracic
62311 Injection, single (not via indwelling catheter), not including neurolytic 30-Sep-08 1
substances, with or without contrast (for either localization or epidurography), of
diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic,
opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal)
62318 Injection, including catheter placement, continuous infusion or intermittent 30-Sep-08 1

bolus, not including neurolytic substances, with or without contrast (for either
localization or epidurography), of diagnostic or therapeutic substance(s)
(including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or
subarachnoid; cervical or thoracic
62319 Injection, including catheter placement, continuous infusion or intermittent 30-Sep-08 1

bolus, not including neurolytic substances, with or without contrast (for either
localization or epidurography), of diagnostic or therapeutic substance(s)
(including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or
subarachnoid; lumbar, sacral (caudal)
62350 Implantation, revision or repositioning of tunneled intrathecal or epidural 30-Sep-08 1

catheter, for long-term medication administration via an external pump or
implantable reservoir/infusion pump; without laminectomy
62351 Implantation, revision or repositioning of tunneled intrathecal or epidural 30-Sep-08 1

catheter, for long-term medication administration via an external pump or
implantable reservoir/infusion pump; with laminectomy
62355 Removal of previously implanted intrathecal or epidural catheter 30-Sep-08 1

62360 Implantation or replacement of device for intrathecal or epidural drug infusion; 30-Sep-08 1
subcutaneous reservoir
nonprogrammable pump
programmable pump, including preparation of pump, with or without
programming
62365 Removal of subcutaneous reservoir or pump, previously implanted for intrathecal 30-Sep-08 1
or epidural infusion
62367 Electronic analysis of programmable, implanted pump for intrathecal or epidural 30-Sep-08 1
drug infusion (includes evaluation of reservoir status, alarm status, drug
prescription status); without reprogramming
62368 Electronic analysis of programmable, implanted pump for intrathecal or epidural 30-Sep-08 1
drug infusion (includes evaluation of reservoir status, alarm status, drug
prescription status); with reprogramming
63001 Laminectomy with exploration and/or decompression of spinal cord and/or cauda 30-Sep-08 1
equina, without facetectomy, foraminotomy or discectomy (eg, spinal stenosis),
1 or 2 vertebral segments; cervical
1 or 2 vertebral segments; thoracic
1 or 2 vertebral segments; lumbar, except for spondylolisthesis
1 or 2 vertebral segments; sacral
63012 Laminectomy with removal of abnormal facets and/or pars inter-articularis with 30-Sep-08 1
decompression of cauda equina and nerve roots for spondylolisthesis, lumbar
(Gill type procedure)
more than 2 vertebral segments; cervical
more than 2 vertebral segments; thoracic
more than 2 vertebral segments; lumbar
63020 Laminotomy (hemilaminectomy), with decompression of nerve root(s), including 30-Sep-08 1

partial facetectomy, foraminotomy and/or excision of herniated intervertebral
disc, including open and endoscopically-assisted approaches; 1 interspace,
cervical
disc, including open and endoscopically-assisted approaches; 1 interspace,
lumbar
disc, including open and endoscopically-assisted approaches; each additional
interspace, cervical or lumbar (List separately in addition to code for primary
procedure)

disc, reexploration, single interspace; cervical

disc, reexploration, single interspace; lumbar

disc, reexploration, single interspace; each additional cervical interspace (List

disc, reexploration, single interspace; each additional lumbar interspace (List
63045 Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with 30-Sep-08 1

decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or
lateral recess stenosis]), single vertebral segment; cervical

lateral recess stenosis]), single vertebral segment; thoracic

lateral recess stenosis]), single vertebral segment; lumbar
lateral recess stenosis]), single vertebral segment; each additional segment,
cervical, thoracic, or lumbar (List separately in addition to code for primary
procedure)
63050 Laminoplasty, cervical, with decompression of the spinal cord, 2 or more 30-Sep-08 1
vertebral segments;
63051 Laminoplasty, cervical, with decompression of the spinal cord, 2 or more 30-Sep-08 1
vertebral segments; with reconstruction of the posterior bony elements
(including the application of bridging bone graft and non-segmental fixation
devices (eg, wire, suture, mini-plates), when performed)
63055 Transpedicular approach with decompression of spinal cord, equina and/or nerve 30-Sep-08 1
root(s) (eg, herniated intervertebral disc), single segment; thoracic
root(s) (eg, herniated intervertebral disc), single segment; lumbar (including
transfacet, or lateral extraforaminal approach) (eg, far lateral herniated
intervertebral disc)
root(s) (eg, herniated intervertebral disc), single segment; each additional
segment, thoracic or lumbar (List separately in addition to code for primary
procedure)
63064 Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, 30-Sep-08 1
herniated intervertebral disc), thoracic; single segment
63066 Costovertebral approach with decompression of spinal cord or nerve root(s) (eg, 30-Sep-08 3
herniated intervertebral disc), thoracic; each additional segment (List separately
63075 Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), 30-Sep-08 1
including osteophytectomy; cervical, single interspace
including osteophytectomy; cervical, each additional interspace (List separately
including osteophytectomy; thoracic, single interspace
including osteophytectomy; thoracic, each additional interspace (List separately
63081 Vertebral corpectomy (vertebral body resection), partial or complete, anterior 30-Sep-08 1
approach with decompression of spinal cord and/or nerve root(s); cervical, single
segment
63082 Vertebral corpectomy (vertebral body resection), partial or complete, anterior 30-Sep-08 6
approach with decompression of spinal cord and/or nerve root(s); cervical, each
additional segment (List separately in addition to code for primary procedure)
63085 Vertebral corpectomy (vertebral body resection), partial or complete, 30-Sep-08 1

transthoracic approach with decompression of spinal cord and/or nerve root(s);
thoracic, single segment
transthoracic approach with decompression of spinal cord and/or nerve root(s);
thoracic, each additional segment (List separately in addition to code for primary
procedure)
63087 Vertebral corpectomy (vertebral body resection), partial or complete, combined 30-Sep-08 1
thoracolumbar approach with decompression of spinal cord, cauda equina or
nerve root(s), lower thoracic or lumbar; single segment
63088 Vertebral corpectomy (vertebral body resection), partial or complete, combined 30-Sep-08 5
thoracolumbar approach with decompression of spinal cord, cauda equina or
nerve root(s), lower thoracic or lumbar; each additional segment (List separately

transperitoneal or retroperitoneal approach with decompression of spinal cord,
cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment
63091 Vertebral corpectomy (vertebral body resection), partial or complete, 30-Sep-08
transperitoneal or retroperitoneal approach with decompression of spinal cord,
cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional
63101 Vertebral corpectomy (vertebral body resection), partial or complete, lateral 30-Sep-08 1
extracavitary approach with decompression of spinal cord and/or nerve root(s)
(eg, for tumor or retropulsed bone fragments); thoracic, single segment
63102 Vertebral corpectomy (vertebral body resection), partial or complete, lateral 30-Sep-08 1
(eg, for tumor or retropulsed bone fragments); lumbar, single segment
63103 Vertebral corpectomy (vertebral body resection), partial or complete, lateral 30-Sep-08
(eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each
additional segment (List separately in addition to code for primary procedure)
63170 Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or 30-Sep-08 1
thoracolumbar
63172 Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space 30-Sep-08 1
63173 Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or 30-Sep-08 1

pleural space
63180 Laminectomy and section of dentate ligaments, with or without dural graft, 30-Sep-08 1
cervical; 1 or 2 segments
63182 Laminectomy and section of dentate ligaments, with or without dural graft, 30-Sep-08 1
cervical; more than 2 segments
63185 Laminectomy with rhizotomy; 1 or 2 segments 30-Sep-08 1
63190 Laminectomy with rhizotomy; more than 2 segments 30-Sep-08 1
63191 Laminectomy with section of spinal accessory nerve 30-Sep-08 1
63194 Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; 30-Sep-08 1
cervical
63195 Laminectomy with cordotomy, with section of 1 spinothalamic tract, 1 stage; 30-Sep-08 1
thoracic
63196 Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; 30-Sep-08 1
cervical
63197 Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage; 30-Sep-08 1
thoracic
63198 Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages 30-Sep-08 1
within 14 days; cervical
63199 Laminectomy with cordotomy with section of both spinothalamic tracts, 2 stages 30-Sep-08 1
within 14 days; thoracic
63200 Laminectomy, with release of tethered spinal cord, lumbar 30-Sep-08 1
63250 Laminectomy for excision or occlusion of arteriovenous malformation of spinal 30-Sep-08 1
cord; cervical
cord; thoracic
cord; thoracolumbar
63265 Laminectomy for excision or evacuation of intraspinal lesion other than 30-Sep-08 1
neoplasm, extradural; cervical
neoplasm, extradural; thoracic
neoplasm, extradural; lumbar
neoplasm, extradural; sacral
63270 Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; 30-Sep-08 1
cervical
thoracic
lumbar
sacral
63275 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical 30-Sep-08 1
63276 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic 30-Sep-08 1
63277 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar 30-Sep-08 1
63278 Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral 30-Sep-08 1
63280 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 30-Sep-08 1

extramedullary, cervical
extramedullary, thoracic
extramedullary, lumbar
63283 Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral 30-Sep-08 1

intramedullary, cervical
intramedullary, thoracic
intramedullary, thoracolumbar
63290 Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural- 30-Sep-08 1
intradural lesion, any level
63295 Osteoplastic reconstruction of dorsal spinal elements, following primary 30-Sep-08 1
intraspinal procedure (List separately in addition to code for primary procedure)
63300 Vertebral corpectomy (vertebral body resection), partial or complete, for excision 30-Sep-08 1
of intraspinal lesion, single segment; extradural, cervical
of intraspinal lesion, single segment; extradural, thoracic by transthoracic
approach
of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar
approach
of intraspinal lesion, single segment; extradural, lumbar or sacral by
transperitoneal or retroperitoneal approach
of intraspinal lesion, single segment; intradural, cervical
of intraspinal lesion, single segment; intradural, thoracic by transthoracic
approach
of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar
approach
of intraspinal lesion, single segment; intradural, lumbar or sacral by
transperitoneal or retroperitoneal approach
of intraspinal lesion, single segment; each additional segment (List separately in
addition to codes for single segment)
63600 Creation of lesion of spinal cord by stereotactic method, percutaneous, any 30-Sep-08 2
modality (including stimulation and/or recording)
63610 Stereotactic stimulation of spinal cord, percutaneous, separate procedure not 30-Sep-08 1
followed by other surgery
63615 Stereotactic biopsy, aspiration, or excision of lesion, spinal cord 30-Sep-08 1
spinal lesion
63621 Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); 15-Oct-12 2
each additional spinal lesion (List separately in addition to code for primary
procedure)
63650 Percutaneous implantation of neurostimulator electrode array, epidural 30-Sep-08 2
63655 Laminectomy for implantation of neurostimulator electrodes, plate/paddle, 30-Sep-08 1

epidural
63660 Revision or removal of spinal neurostimulator electrode percutaneous array(s) or 30-Sep-08 14-Oct-12
plate/paddle(s)
63661 Removal of spinal neurostimulator electrode percutaneous array(s), including 15-Oct-12 1
fluoroscopy, when performed
63662 Removal of spinal neurostimulator electrode plate/paddle(s) placed via 15-Oct-12 1
laminotomy or laminectomy, including fluoroscopy, when performed
63663 Revision including replacement, when performed, of spinal neurostimulator 15-Oct-12

electrode percutaneous array(s), including fluoroscopy, when performed
63664 Revision including replacement, when performed, of spinal neurostimulator 15-Oct-12

electrode plate/paddle(s) placed via laminotomy or laminectomy, including
fluoroscopy, when performed
63685 Insertion or replacement of spinal neurostimulator pulse generator or receiver, 30-Sep-08 2
direct or inductive coupling
63688 Revision or removal of implanted spinal neurostimulator pulse generator or 30-Sep-08 2
receiver
63700 Repair of meningocele; less than 5 cm diameter 30-Sep-08 1
63702 Repair of meningocele; larger than 5 cm diameter 30-Sep-08 1
63704 Repair of myelomeningocele; less than 5 cm diameter 30-Sep-08 1
63706 Repair of myelomeningocele; larger than 5 cm diameter 30-Sep-08 1
63707 Repair of dural/cerebrospinal fluid leak, not requiring laminectomy 30-Sep-08 1
63709 Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy 30-Sep-08 1
63710 Dural graft, spinal 30-Sep-08 1

63740 Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including 30-Sep-08 1
laminectomy
63741 Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; 30-Sep-08 1
percutaneous, not requiring laminectomy
63744 Replacement, irrigation or revision of lumbosubarachnoid shunt 30-Sep-08 1
63746 Removal of entire lumbosubarachnoid shunt system without replacement 30-Sep-08 1
64400 Injection, anesthetic agent; trigeminal nerve, any division or branch 30-Sep-08
64402 Injection, anesthetic agent; facial nerve 30-Sep-08 2
64405 Injection, anesthetic agent; greater occipital nerve 30-Sep-08 1
64408 Injection, anesthetic agent; vagus nerve 30-Sep-08 2
64410 Injection, anesthetic agent; phrenic nerve 30-Sep-08 2
64412 Injection, anesthetic agent; spinal accessory nerve 30-Sep-08 2
64413 Injection, anesthetic agent; cervical plexus 30-Sep-08 2
64415 Injection, anesthetic agent; brachial plexus, single 30-Sep-08 2
64416 Injection, anesthetic agent; brachial plexus, continuous infusion by catheter 30-Sep-08 2
(including catheter placement)
64417 Injection, anesthetic agent; axillary nerve 30-Sep-08 2
64418 Injection, anesthetic agent; suprascapular nerve 30-Sep-08 2
64420 Injection, anesthetic agent; intercostal nerve, single 30-Sep-08 3
64421 Injection, anesthetic agent; intercostal nerves, multiple, regional block 30-Sep-08 3
64425 Injection, anesthetic agent; ilioinguinal, iliohypogastric nerves 30-Sep-08 2

64430 Injection, anesthetic agent; pudendal nerve 30-Sep-08 2
64435 Injection, anesthetic agent; paracervical (uterine) nerve 30-Sep-08 2
64445 Injection, anesthetic agent; sciatic nerve, single 30-Sep-08 1
64446 Injection, anesthetic agent; sciatic nerve, continuous infusion by catheter 30-Sep-08 2
64447 Injection, anesthetic agent; femoral nerve, single 30-Sep-08 2
64448 Injection, anesthetic agent; femoral nerve, continuous infusion by catheter 30-Sep-08 2
64449 Injection, anesthetic agent; lumbar plexus, posterior approach, continuous 30-Sep-08 2
infusion by catheter (including catheter placement)
64450 Injection, anesthetic agent; other peripheral nerve or branch 30-Sep-08
64455 Injection(s), anesthetic agent and/or steroid, plantar common digital nerve(s) 15-Oct-12 1
(eg, Morton's neuroma)
64470 Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint 30-Sep-08 14-Oct-12
nerve; cervical or thoracic, single level
nerve; cervical or thoracic, each additional level (List separately in addition to
nerve; lumbar or sacral, single level
nerve; lumbar or sacral, each additional level (List separately in addition to code
64479 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 30-Sep-08 1
imaging guidance (fluoroscopy or CT); cervical or thoracic, single level
64480 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 30-Sep-08
imaging guidance (fluoroscopy or CT); cervical or thoracic, each additional level
64483 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 30-Sep-08 1
imaging guidance (fluoroscopy or CT); lumbar or sacral, single level
64484 Injection(s), anesthetic agent and/or steroid, transforaminal epidural, with 30-Sep-08
imaging guidance (fluoroscopy or CT); lumbar or sacral, each additional level
64490 Injection(s), diagnostic or therapeutic agent, paravertebral facet 15-Oct-12

(zygapophyseal) joint (or nerves innervating that joint) with image guidance
(fluoroscopy or CT), cervical or thoracic; single level
(fluoroscopy or CT), cervical or thoracic; second level (List separately in addition
(fluoroscopy or CT), cervical or thoracic; third and any additional level(s) (List

(fluoroscopy or CT), lumbar or sacral; single level
(fluoroscopy or CT), lumbar or sacral; second level (List separately in addition to
(fluoroscopy or CT), lumbar or sacral; third and any additional level(s) (List
64505 Injection, anesthetic agent; sphenopalatine ganglion 30-Sep-08 2

64508 Injection, anesthetic agent; carotid sinus (separate procedure) 30-Sep-08 2
64510 Injection, anesthetic agent; stellate ganglion (cervical sympathetic) 30-Sep-08 2
64517 Injection, anesthetic agent; superior hypogastric plexus 30-Sep-08 1
64520 Injection, anesthetic agent; lumbar or thoracic (paravertebral sympathetic) 30-Sep-08 2
64530 Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring 30-Sep-08 2
64550 Application of surface (transcutaneous) neurostimulator 30-Sep-08

64553 Percutaneous implantation of neurostimulator electrodes; cranial nerve 30-Sep-08 1
64555 Percutaneous implantation of neurostimulator electrodes; peripheral nerve 30-Sep-08 2

(excludes sacral nerve)
64560 Percutaneous implantation of neurostimulator electrodes; autonomic nerve 30-Sep-08 1
64561 Percutaneous implantation of neurostimulator electrodes; sacral nerve 30-Sep-08 2

(transforaminal placement)
64565 Percutaneous implantation of neurostimulator electrodes; neuromuscular 30-Sep-08 2
64566 Posterior tibial neurostimulation, percutaneous needle electrode, single 15-Oct-12 1

treatment, includes programming
64568 Incision for implantation of cranial nerve (eg, vagus nerve) neurostimulator 15-Oct-12 2
electrode array and pulse generator
64569 Revision or replacement of cranial nerve (eg, vagus nerve) neurostimulator 15-Oct-12 2
electrode array, including connection to existing pulse generator
64570 Removal of cranial nerve (eg, vagus nerve) neurostimulator electrode array and 15-Oct-12 2
pulse generator
64573 Incision for implantation of neurostimulator electrodes; cranial nerve 30-Sep-08 14-Oct-12
64575 Incision for implantation of neurostimulator electrodes; peripheral nerve 30-Sep-08 2
(excludes sacral nerve)
64577 Incision for implantation of neurostimulator electrodes; autonomic nerve 30-Sep-08 1
64580 Incision for implantation of neurostimulator electrodes; neuromuscular 30-Sep-08 2
64581 Incision for implantation of neurostimulator electrodes; sacral nerve 30-Sep-08 2

(transforaminal placement)
64585 Revision or removal of peripheral neurostimulator electrodes 30-Sep-08 2
64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator 30-Sep-08 1
or receiver, direct or inductive coupling
64595 Revision or removal of peripheral or gastric neurostimulator pulse generator or 30-Sep-08 1
receiver
64600 Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, 30-Sep-08 2
mental, or inferior alveolar branch
64605 Destruction by neurolytic agent, trigeminal nerve; second and third division 30-Sep-08 2
branches at foramen ovale
64610 Destruction by neurolytic agent, trigeminal nerve; second and third division 30-Sep-08 2
branches at foramen ovale under radiologic monitoring
64611 Chemodenervation of parotid and submandibular salivary glands, bilateral 15-Oct-12 1
64612 Chemodenervation of muscle(s); muscle(s) innervated by facial nerve (eg, for 30-Sep-08 2
blepharospasm, hemifacial spasm)
64613 Chemodenervation of muscle(s); neck muscle(s) (eg, for spasmodic torticollis, 30-Sep-08 1
spasmodic dysphonia)
64614 Chemodenervation of muscle(s); extremity(s) and/or trunk muscle(s) (eg, for 30-Sep-08 1
dystonia, cerebral palsy, multiple sclerosis)
64620 Destruction by neurolytic agent, intercostal nerve 30-Sep-08
64622 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or 30-Sep-08 1
sacral, single level
64623 Destruction by neurolytic agent, paravertebral facet joint nerve; lumbar or 30-Sep-08
sacral, each additional level (List separately in addition to code for primary
procedure)
64626 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or 30-Sep-08 1
thoracic, single level
64627 Destruction by neurolytic agent, paravertebral facet joint nerve; cervical or 30-Sep-08
thoracic, each additional level (List separately in addition to code for primary
procedure)
64630 Destruction by neurolytic agent; pudendal nerve 30-Sep-08 1
64632 Destruction by neurolytic agent; plantar common digital nerve 15-Oct-12 2
64640 Destruction by neurolytic agent; other peripheral nerve or branch 30-Sep-08
64650 Chemodenervation of eccrine glands; both axillae 30-Sep-08 1
64653 Chemodenervation of eccrine glands; other area(s) (eg, scalp, face, neck), per 30-Sep-08 1
day
64680 Destruction by neurolytic agent, with or without radiologic monitoring; celiac 30-Sep-08 1
plexus
64681 Destruction by neurolytic agent, with or without radiologic monitoring; superior 30-Sep-08 1
hypogastric plexus
64702 Neuroplasty; digital, 1 or both, same digit 30-Sep-08 2
64704 Neuroplasty; nerve of hand or foot 30-Sep-08
64708 Neuroplasty, major peripheral nerve, arm or leg, open; other than specified 30-Sep-08
64712 Neuroplasty, major peripheral nerve, arm or leg, open; sciatic nerve 30-Sep-08 2
64713 Neuroplasty, major peripheral nerve, arm or leg, open; brachial plexus 30-Sep-08 2
64714 Neuroplasty, major peripheral nerve, arm or leg, open; lumbar plexus 30-Sep-08 2
64716 Neuroplasty and/or transposition; cranial nerve (specify) 30-Sep-08
64718 Neuroplasty and/or transposition; ulnar nerve at elbow 30-Sep-08 2
64719 Neuroplasty and/or transposition; ulnar nerve at wrist 30-Sep-08 2
64721 Neuroplasty and/or transposition; median nerve at carpal tunnel 30-Sep-08 2
64722 Decompression; unspecified nerve(s) (specify) 30-Sep-08
64726 Decompression; plantar digital nerve 30-Sep-08 2
64727 Internal neurolysis, requiring use of operating microscope (List separately in 30-Sep-08 3
addition to code for neuroplasty) (Neuroplasty includes external neurolysis)
64732 Transection or avulsion of; supraorbital nerve 30-Sep-08 2

64734 Transection or avulsion of; infraorbital nerve 30-Sep-08 2
64736 Transection or avulsion of; mental nerve 30-Sep-08 2
64738 Transection or avulsion of; inferior alveolar nerve by osteotomy 30-Sep-08 2
64740 Transection or avulsion of; lingual nerve 30-Sep-08 2
64742 Transection or avulsion of; facial nerve, differential or complete 30-Sep-08 2
64744 Transection or avulsion of; greater occipital nerve 30-Sep-08 2
64746 Transection or avulsion of; phrenic nerve 30-Sep-08 2
64752 Transection or avulsion of; vagus nerve (vagotomy), transthoracic 30-Sep-08 1
64755 Transection or avulsion of; vagus nerves limited to proximal stomach (selective 30-Sep-08 1
proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- or
highly selective vagotomy)
64760 Transection or avulsion of; vagus nerve (vagotomy), abdominal 30-Sep-08 1
64761 Transection or avulsion of; pudendal nerve 30-Sep-08 1
64763 Transection or avulsion of obturator nerve, extrapelvic, with or without adductor 30-Sep-08 1
tenotomy
64766 Transection or avulsion of obturator nerve, intrapelvic, with or without adductor 30-Sep-08 1
tenotomy
64771 Transection or avulsion of other cranial nerve, extradural 30-Sep-08 2
64772 Transection or avulsion of other spinal nerve, extradural 30-Sep-08 2
64774 Excision of neuroma; cutaneous nerve, surgically identifiable 30-Sep-08 3
64776 Excision of neuroma; digital nerve, 1 or both, same digit 30-Sep-08 1
64778 Excision of neuroma; digital nerve, each additional digit (List separately in 30-Sep-08 3
64782 Excision of neuroma; hand or foot, except digital nerve 30-Sep-08 2
64783 Excision of neuroma; hand or foot, each additional nerve, except same digit (List 30-Sep-08 2
64784 Excision of neuroma; major peripheral nerve, except sciatic 30-Sep-08
64786 Excision of neuroma; sciatic nerve 30-Sep-08 2
64787 Implantation of nerve end into bone or muscle (List separately in addition to 30-Sep-08
neuroma excision)
64788 Excision of neurofibroma or neurolemmoma; cutaneous nerve 30-Sep-08
64790 Excision of neurofibroma or neurolemmoma; major peripheral nerve 30-Sep-08 1
64792 Excision of neurofibroma or neurolemmoma; extensive (including malignant 30-Sep-08 2
type)
64795 Biopsy of nerve 30-Sep-08 2
64802 Sympathectomy, cervical 30-Sep-08 1
64804 Sympathectomy, cervicothoracic 30-Sep-08 1
64809 Sympathectomy, thoracolumbar 30-Sep-08 1
64818 Sympathectomy, lumbar 30-Sep-08 1
64820 Sympathectomy; digital arteries, each digit 30-Sep-08
64821 Sympathectomy; radial artery 30-Sep-08 2
64822 Sympathectomy; ulnar artery 30-Sep-08 2
64823 Sympathectomy; superficial palmar arch 30-Sep-08 2
64831 Suture of digital nerve, hand or foot; 1 nerve 30-Sep-08 2
64832 Suture of digital nerve, hand or foot; each additional digital nerve (List 30-Sep-08
64834 Suture of 1 nerve; hand or foot, common sensory nerve 30-Sep-08 2
64835 Suture of 1 nerve; median motor thenar 30-Sep-08 2
64836 Suture of 1 nerve; ulnar motor 30-Sep-08 2
64837 Suture of each additional nerve, hand or foot (List separately in addition to code 30-Sep-08 3
64840 Suture of posterior tibial nerve 30-Sep-08 2
64856 Suture of major peripheral nerve, arm or leg, except sciatic; including 30-Sep-08 2
transposition
64857 Suture of major peripheral nerve, arm or leg, except sciatic; without transposition 30-Sep-08 3
64858 Suture of sciatic nerve 30-Sep-08 2

64859 Suture of each additional major peripheral nerve (List separately in addition to 30-Sep-08 2
64861 Suture of; brachial plexus 30-Sep-08 2
64862 Suture of; lumbar plexus 30-Sep-08 2
64864 Suture of facial nerve; extracranial 30-Sep-08 2
64865 Suture of facial nerve; infratemporal, with or without grafting 30-Sep-08 1
64866 Anastomosis; facial-spinal accessory 30-Sep-08 1
64868 Anastomosis; facial-hypoglossal 30-Sep-08 1
64870 Anastomosis; facial-phrenic 30-Sep-08 1
64872 Suture of nerve; requiring secondary or delayed suture (List separately in 30-Sep-08 3
addition to code for primary neurorrhaphy)
64874 Suture of nerve; requiring extensive mobilization, or transposition of nerve (List 30-Sep-08 1
separately in addition to code for nerve suture)
64876 Suture of nerve; requiring shortening of bone of extremity (List separately in 30-Sep-08 1
addition to code for nerve suture)
64885 Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length 30-Sep-08 1
64886 Nerve graft (includes obtaining graft), head or neck; more than 4 cm length 30-Sep-08 1
64890 Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm 30-Sep-08 3
length
64891 Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 30-Sep-08 2
cm length
64892 Nerve graft (includes obtaining graft), single strand, arm or leg; up to 4 cm 30-Sep-08 2
length
64893 Nerve graft (includes obtaining graft), single strand, arm or leg; more than 4 cm 30-Sep-08 2
length
64895 Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; up 30-Sep-08 2
to 4 cm length
64896 Nerve graft (includes obtaining graft), multiple strands (cable), hand or foot; 30-Sep-08 2
more than 4 cm length
64897 Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; up to 30-Sep-08 2
4 cm length
64898 Nerve graft (includes obtaining graft), multiple strands (cable), arm or leg; more 30-Sep-08 2
than 4 cm length
64901 Nerve graft, each additional nerve; single strand (List separately in addition to 30-Sep-08 2
64902 Nerve graft, each additional nerve; multiple strands (cable) (List separately in 30-Sep-08
64905 Nerve pedicle transfer; first stage 30-Sep-08 1
64907 Nerve pedicle transfer; second stage 30-Sep-08 1
64910 Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve 30-Sep-08 3
64911 Nerve repair; with autogenous vein graft (includes harvest of vein graft), each 30-Sep-08 2
nerve
64999 Unlisted procedure, nervous system 30-Sep-08
65091 Evisceration of ocular contents; without implant 30-Sep-08 2

65093 Evisceration of ocular contents; with implant 30-Sep-08 2
65101 Enucleation of eye; without implant 30-Sep-08 2
65103 Enucleation of eye; with implant, muscles not attached to implant 30-Sep-08 2
65105 Enucleation of eye; with implant, muscles attached to implant 30-Sep-08 2
65110 Exenteration of orbit (does not include skin graft), removal of orbital contents; 30-Sep-08 2
only
with therapeutic removal of bone
with muscle or myocutaneous flap
65125 Modification of ocular implant with placement or replacement of pegs (eg, 30-Sep-08 2
drilling receptacle for prosthesis appendage) (separate procedure)
65130 Insertion of ocular implant secondary; after evisceration, in scleral shell 30-Sep-08 2
65135 Insertion of ocular implant secondary; after enucleation, muscles not attached to 30-Sep-08 2
implant
65140 Insertion of ocular implant secondary; after enucleation, muscles attached to 30-Sep-08 2
implant
65150 Reinsertion of ocular implant; with or without conjunctival graft 30-Sep-08 2
65155 Reinsertion of ocular implant; with use of foreign material for reinforcement 30-Sep-08 2
and/or attachment of muscles to implant
65175 Removal of ocular implant 30-Sep-08 2
65205 Removal of foreign body, external eye; conjunctival superficial 30-Sep-08 2
65210 Removal of foreign body, external eye; conjunctival embedded (includes 30-Sep-08 2
concretions), subconjunctival, or scleral nonperforating
65220 Removal of foreign body, external eye; corneal, without slit lamp 30-Sep-08 2
65222 Removal of foreign body, external eye; corneal, with slit lamp 30-Sep-08 2
65235 Removal of foreign body, intraocular; from anterior chamber of eye or lens 30-Sep-08 2
65260 Removal of foreign body, intraocular; from posterior segment, magnetic 30-Sep-08 2
extraction, anterior or posterior route
65265 Removal of foreign body, intraocular; from posterior segment, nonmagnetic 30-Sep-08 2
extraction
65270 Repair of laceration; conjunctiva, with or without nonperforating laceration 30-Sep-08 2
sclera, direct closure
65272 Repair of laceration; conjunctiva, by mobilization and rearrangement, without 30-Sep-08 2
hospitalization
65273 Repair of laceration; conjunctiva, by mobilization and rearrangement, with 30-Sep-08 2
hospitalization
65275 Repair of laceration; cornea, nonperforating, with or without removal foreign 30-Sep-08 2
body
65280 Repair of laceration; cornea and/or sclera, perforating, not involving uveal tissue 30-Sep-08 2
65285 Repair of laceration; cornea and/or sclera, perforating, with reposition or 30-Sep-08 2
resection of uveal tissue
65286 Repair of laceration; application of tissue glue, wounds of cornea and/or sclera 30-Sep-08 2
65290 Repair of wound, extraocular muscle, tendon and/or Tenon's capsule 30-Sep-08 2
65400 Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium 30-Sep-08 2
65410 Biopsy of cornea 30-Sep-08 2

65420 Excision or transposition of pterygium; without graft 30-Sep-08 2
65426 Excision or transposition of pterygium; with graft 30-Sep-08 2
65430 Scraping of cornea, diagnostic, for smear and/or culture 30-Sep-08 2
65435 Removal of corneal epithelium; with or without chemocauterization (abrasion, 30-Sep-08 2
curettage)
65436 Removal of corneal epithelium; with application of chelating agent (eg, EDTA) 30-Sep-08 2
65450 Destruction of lesion of cornea by cryotherapy, photocoagulation or 30-Sep-08 2

thermocauterization
65600 Multiple punctures of anterior cornea (eg, for corneal erosion, tattoo) 30-Sep-08 2
65710 Keratoplasty (corneal transplant); anterior lamellar 30-Sep-08 2
65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or 30-Sep-08 2

pseudophakia)
65750 Keratoplasty (corneal transplant); penetrating (in aphakia) 30-Sep-08 2
65755 Keratoplasty (corneal transplant); penetrating (in pseudophakia) 30-Sep-08 2
65756 Keratoplasty (corneal transplant); endothelial 15-Oct-12 2

65757 Backbench preparation of corneal endothelial allograft prior to transplantation 15-Oct-12 2
65760 Keratomileusis 30-Sep-08
65765 Keratophakia 30-Sep-08
65767 Epikeratoplasty 30-Sep-08
65770 Keratoprosthesis 30-Sep-08 2

65771 Radial keratotomy 30-Sep-08
65772 Corneal relaxing incision for correction of surgically induced astigmatism 30-Sep-08 2
65775 Corneal wedge resection for correction of surgically induced astigmatism 30-Sep-08 2
65778 Placement of amniotic membrane on the ocular surface for wound healing; self- 15-Oct-12 2
retaining
65779 Placement of amniotic membrane on the ocular surface for wound healing; 15-Oct-12 2
single layer, sutured
65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple 30-Sep-08 2
layers
65781 Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living 30-Sep-08 2
donor)
65782 Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining 30-Sep-08 2
graft)
65800 Paracentesis of anterior chamber of eye (separate procedure); with diagnostic 30-Sep-08 2
aspiration of aqueous
65805 Paracentesis of anterior chamber of eye (separate procedure); with therapeutic 30-Sep-08 2
release of aqueous
65810 Paracentesis of anterior chamber of eye (separate procedure); with removal of 30-Sep-08 2
vitreous and/or discission of anterior hyaloid membrane, with or without air
injection
65815 Paracentesis of anterior chamber of eye (separate procedure); with removal of 30-Sep-08 2
blood, with or without irrigation and/or air injection
65820 Goniotomy 30-Sep-08 2
65850 Trabeculotomy ab externo 30-Sep-08 2
65855 Trabeculoplasty by laser surgery, 1 or more sessions (defined treatment series) 30-Sep-08 2
65860 Severing adhesions of anterior segment, laser technique (separate procedure) 30-Sep-08 2
65865 Severing adhesions of anterior segment of eye, incisional technique (with or 30-Sep-08 2
without injection of air or liquid) (separate procedure); goniosynechiae
without injection of air or liquid) (separate procedure); anterior synechiae,
except goniosynechiae
without injection of air or liquid) (separate procedure); posterior synechiae
without injection of air or liquid) (separate procedure); corneovitreal adhesions
65900 Removal of epithelial downgrowth, anterior chamber of eye 30-Sep-08 2

65920 Removal of implanted material, anterior segment of eye 30-Sep-08 2
65930 Removal of blood clot, anterior segment of eye 30-Sep-08 2
66020 Injection, anterior chamber of eye (separate procedure); air or liquid 30-Sep-08 2
66030 Injection, anterior chamber of eye (separate procedure); medication 30-Sep-08 2
66130 Excision of lesion, sclera 30-Sep-08 2
66150 Fistulization of sclera for glaucoma; trephination with iridectomy 30-Sep-08 2
66155 Fistulization of sclera for glaucoma; thermocauterization with iridectomy 30-Sep-08 2
66160 Fistulization of sclera for glaucoma; sclerectomy with punch or scissors, with 30-Sep-08 2
iridectomy
66165 Fistulization of sclera for glaucoma; iridencleisis or iridotasis 30-Sep-08 2
66170 Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of 30-Sep-08 2
previous surgery
66172 Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring 30-Sep-08 2
from previous ocular surgery or trauma (includes injection of antifibrotic agents)
66174 Transluminal dilation of aqueous outflow canal; without retention of device or 15-Oct-12 2
stent
66175 Transluminal dilation of aqueous outflow canal; with retention of device or stent 15-Oct-12 2
66180 Aqueous shunt to extraocular reservoir (eg, Molteno, Schocket, Denver-Krupin) 30-Sep-08 2
66185 Revision of aqueous shunt to extraocular reservoir 30-Sep-08 2

66220 Repair of scleral staphyloma; without graft 30-Sep-08 2
66225 Repair of scleral staphyloma; with graft 30-Sep-08 2
66250 Revision or repair of operative wound of anterior segment, any type, early or 30-Sep-08 2
late, major or minor procedure
66500 Iridotomy by stab incision (separate procedure); except transfixion 30-Sep-08 2
66505 Iridotomy by stab incision (separate procedure); with transfixion as for iris 30-Sep-08 2
bombe
66600 Iridectomy, with corneoscleral or corneal section; for removal of lesion 30-Sep-08 2
66605 Iridectomy, with corneoscleral or corneal section; with cyclectomy 30-Sep-08 2

66625 Iridectomy, with corneoscleral or corneal section; peripheral for glaucoma 30-Sep-08 2
66630 Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate 30-Sep-08 2
procedure)
66635 Iridectomy, with corneoscleral or corneal section; optical (separate procedure) 30-Sep-08 2
66680 Repair of iris, ciliary body (as for iridodialysis) 30-Sep-08 2

66682 Suture of iris, ciliary body (separate procedure) with retrieval of suture through 30-Sep-08 2
small incision (eg, McCannel suture)
66700 Ciliary body destruction; diathermy 30-Sep-08 2
66710 Ciliary body destruction; cyclophotocoagulation, transscleral 30-Sep-08 2
66711 Ciliary body destruction; cyclophotocoagulation, endoscopic 30-Sep-08 2
66720 Ciliary body destruction; cryotherapy 30-Sep-08 2
66740 Ciliary body destruction; cyclodialysis 30-Sep-08 2
66761 Iridotomy/iridectomy by laser surgery (eg, for glaucoma) (per session) 30-Sep-08 2
66762 Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of 30-Sep-08 2

vision, for widening of anterior chamber angle)
66770 Destruction of cyst or lesion iris or ciliary body (nonexcisional procedure) 30-Sep-08 2
66820 Discission of secondary membranous cataract (opacified posterior lens capsule 30-Sep-08 2
and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife)
66821 Discission of secondary membranous cataract (opacified posterior lens capsule 30-Sep-08 2
and/or anterior hyaloid); laser surgery (eg, YAG laser) (1 or more stages)
66825 Repositioning of intraocular lens prosthesis, requiring an incision (separate 30-Sep-08 2

procedure)
66830 Removal of secondary membranous cataract (opacified posterior lens capsule 30-Sep-08 2
and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy
(iridocapsulotomy, iridocapsulectomy)
66840 Removal of lens material; aspiration technique, 1 or more stages 30-Sep-08 2
66850 Removal of lens material; phacofragmentation technique (mechanical or 30-Sep-08 2
ultrasonic) (eg, phacoemulsification), with aspiration
66852 Removal of lens material; pars plana approach, with or without vitrectomy 30-Sep-08 2
66920 Removal of lens material; intracapsular 30-Sep-08 2

66930 Removal of lens material; intracapsular, for dislocated lens 30-Sep-08 2
66940 Removal of lens material; extracapsular (other than 66840, 66850, 66852) 30-Sep-08 2
66982 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1- 30-Sep-08 2
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
66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 30-Sep-08 2
stage procedure)
66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 30-Sep-08 2
stage procedure), manual or mechanical technique (eg, irrigation and aspiration
or phacoemulsification)
66985 Insertion of intraocular lens prosthesis (secondary implant), not associated with 30-Sep-08 2
concurrent cataract removal
66986 Exchange of intraocular lens 30-Sep-08 2
66990 Use of ophthalmic endoscope (List separately in addition to code for primary 30-Sep-08 2
procedure)
66999 Unlisted procedure, anterior segment of eye 30-Sep-08
67005 Removal of vitreous, anterior approach (open sky technique or limbal incision); 30-Sep-08 2
partial removal
67010 Removal of vitreous, anterior approach (open sky technique or limbal incision); 30-Sep-08 2
subtotal removal with mechanical vitrectomy
67015 Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana 30-Sep-08 2
approach (posterior sclerotomy)
67025 Injection of vitreous substitute, pars plana or limbal approach (fluid-gas 30-Sep-08 2
exchange), with or without aspiration (separate procedure)
67027 Implantation of intravitreal drug delivery system (eg, ganciclovir implant), 30-Sep-08 2
includes concomitant removal of vitreous
67028 Intravitreal injection of a pharmacologic agent (separate procedure) 30-Sep-08 2
67030 Discission of vitreous strands (without removal), pars plana approach 30-Sep-08 2
67031 Severing of vitreous strands, vitreous face adhesions, sheets, membranes or 30-Sep-08 2
opacities, laser surgery (1 or more stages)
67036 Vitrectomy, mechanical, pars plana approach; 30-Sep-08 2
67039 Vitrectomy, mechanical, pars plana approach; with focal endolaser 30-Sep-08 2
photocoagulation
67040 Vitrectomy, mechanical, pars plana approach; with endolaser panretinal 30-Sep-08 2
photocoagulation
67041 Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular 30-Sep-08 2
membrane (eg, macular pucker)
67042 Vitrectomy, mechanical, pars plana approach; with removal of internal limiting 30-Sep-08 2
membrane of retina (eg, for repair of macular hole, diabetic macular edema),
includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)
67043 Vitrectomy, mechanical, pars plana approach; with removal of subretinal 30-Sep-08 2
membrane (eg, choroidal neovascularization), includes, if performed, intraocular
tamponade (ie, air, gas or silicone oil) and laser photocoagulation
67101 Repair of retinal detachment, 1 or more sessions; cryotherapy or diathermy, with 30-Sep-08 2
or without drainage of subretinal fluid
67105 Repair of retinal detachment, 1 or more sessions; photocoagulation, with or 30-Sep-08 2
without drainage of subretinal fluid
67107 Repair of retinal detachment; scleral buckling (such as lamellar scleral 30-Sep-08 2
dissection, imbrication or encircling procedure), with or without implant, with or
without cryotherapy, photocoagulation, and drainage of subretinal fluid
67108 Repair of retinal detachment; with vitrectomy, any method, with or without air or 30-Sep-08 2
gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of
subretinal fluid, scleral buckling, and/or removal of lens by same technique
67110 Repair of retinal detachment; by injection of air or other gas (eg, pneumatic 30-Sep-08 2
retinopexy)
67112 Repair of retinal detachment; by scleral buckling or vitrectomy, on patient 30-Sep-08 2
having previous ipsilateral retinal detachment repair(s) using scleral buckling or
vitrectomy techniques
67113 Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage 30-Sep-08 2
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) 30-Sep-08 2

67120 Removal of implanted material, posterior segment; extraocular 30-Sep-08 2
67121 Removal of implanted material, posterior segment; intraocular 30-Sep-08 2
67141 Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) 30-Sep-08 2
without drainage, 1 or more sessions; cryotherapy, diathermy
67145 Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) 30-Sep-08 2
without drainage, 1 or more sessions; photocoagulation (laser or xenon arc)
67208 Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more 30-Sep-08 2
sessions; cryotherapy, diathermy
sessions; photocoagulation
sessions; radiation by implantation of source (includes removal of source)
67220 Destruction of localized lesion of choroid (eg, choroidal neovascularization); 30-Sep-08 2

photocoagulation (eg, laser), 1 or more sessions
photodynamic therapy (includes intravenous infusion)

photodynamic therapy, second eye, at single session (List separately in addition
to code for primary eye treatment)
67227 Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), 1 30-Sep-08 2
or more sessions, cryotherapy, diathermy
67228 Treatment of extensive or progressive retinopathy, 1 or more sessions; (eg, 30-Sep-08 2
diabetic retinopathy), photocoagulation
67229 Treatment of extensive or progressive retinopathy, 1 or more sessions; preterm 30-Sep-08 1
infant (less than 37 weeks gestation at birth), performed from birth up to 1 year
of age (eg, retinopathy of prematurity), photocoagulation or cryotherapy
67250 Scleral reinforcement (separate procedure); without graft 30-Sep-08 2
67255 Scleral reinforcement (separate procedure); with graft 30-Sep-08 2
67299 Unlisted procedure, posterior segment 30-Sep-08
67311 Strabismus surgery, recession or resection procedure; 1 horizontal muscle 30-Sep-08 2
67312 Strabismus surgery, recession or resection procedure; 2 horizontal muscles 30-Sep-08 2
67314 Strabismus surgery, recession or resection procedure; 1 vertical muscle 30-Sep-08 2

(excluding superior oblique)
67316 Strabismus surgery, recession or resection procedure; 2 or more vertical muscles 30-Sep-08 2
(excluding superior oblique)
67318 Strabismus surgery, any procedure, superior oblique muscle 30-Sep-08 2
67320 Transposition procedure (eg, for paretic extraocular muscle), any extraocular 30-Sep-08 2
muscle (specify) (List separately in addition to code for primary procedure)
67331 Strabismus surgery on patient with previous eye surgery or injury that did not 30-Sep-08 2
involve the extraocular muscles (List separately in addition to code for primary
procedure)
67332 Strabismus surgery on patient with scarring of extraocular muscles (eg, prior 30-Sep-08 2
ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy
(eg, dysthyroid ophthalmopathy) (List separately in addition to code for primary
procedure)
67334 Strabismus surgery by posterior fixation suture technique, with or without 30-Sep-08 2
muscle recession (List separately in addition to code for primary procedure)
67335 Placement of adjustable suture(s) during strabismus surgery, including 30-Sep-08 2

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 30-Sep-08 2
muscle(s) (List separately in addition to code for primary procedure)
67343 Release of extensive scar tissue without detaching extraocular muscle (separate 30-Sep-08 2
procedure)
67345 Chemodenervation of extraocular muscle 30-Sep-08 2
67346 Biopsy of extraocular muscle 30-Sep-08 1
67399 Unlisted procedure, ocular muscle 30-Sep-08
67400 Orbitotomy without bone flap (frontal or transconjunctival approach); for 30-Sep-08 2
exploration, with or without biopsy
67405 Orbitotomy without bone flap (frontal or transconjunctival approach); with 30-Sep-08 2
drainage only
removal of lesion
removal of bone for decompression
67415 Fine needle aspiration of orbital contents 30-Sep-08 2
67420 Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); with 30-Sep-08 2
removal of lesion
drainage
removal of bone for decompression
67450 Orbitotomy with bone flap or window, lateral approach (eg, Kroenlein); for 30-Sep-08 2
exploration, with or without biopsy
67500 Retrobulbar injection; medication (separate procedure, does not include supply 30-Sep-08 2
of medication)
67505 Retrobulbar injection; alcohol 30-Sep-08 2
67515 Injection of medication or other substance into Tenon's capsule 30-Sep-08 2
67550 Orbital implant (implant outside muscle cone); insertion 30-Sep-08 2
67560 Orbital implant (implant outside muscle cone); removal or revision 30-Sep-08 2
67570 Optic nerve decompression (eg, incision or fenestration of optic nerve sheath) 30-Sep-08 2
67599 Unlisted procedure, orbit 30-Sep-08
67700 Blepharotomy, drainage of abscess, eyelid 30-Sep-08 4

67710 Severing of tarsorrhaphy 30-Sep-08 2
67715 Canthotomy (separate procedure) 30-Sep-08 2
67800 Excision of chalazion; single 30-Sep-08 1
67801 Excision of chalazion; multiple, same lid 30-Sep-08 1
67805 Excision of chalazion; multiple, different lids 30-Sep-08 1
67808 Excision of chalazion; under general anesthesia and/or requiring hospitalization, 30-Sep-08 1
single or multiple
67810 Biopsy of eyelid 30-Sep-08
67820 Correction of trichiasis; epilation, by forceps only 30-Sep-08 2
67825 Correction of trichiasis; epilation by other than forceps (eg, by electrosurgery, 30-Sep-08 2
cryotherapy, laser surgery)
67830 Correction of trichiasis; incision of lid margin 30-Sep-08 3
67835 Correction of trichiasis; incision of lid margin, with free mucous membrane graft 30-Sep-08 2
67840 Excision of lesion of eyelid (except chalazion) without closure or with simple 30-Sep-08
direct closure
67850 Destruction of lesion of lid margin (up to 1 cm) 30-Sep-08 4
67875 Temporary closure of eyelids by suture (eg, Frost suture) 30-Sep-08 2
67880 Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy; 30-Sep-08 2
67882 Construction of intermarginal adhesions, median tarsorrhaphy, or 30-Sep-08 2

canthorrhaphy; with transposition of tarsal plate
67900 Repair of brow ptosis (supraciliary, mid-forehead or coronal approach) 30-Sep-08 2
67901 Repair of blepharoptosis; frontalis muscle technique with suture or other 30-Sep-08 2
material (eg, banked fascia)
67902 Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling 30-Sep-08 2
(includes obtaining fascia)
67903 Repair of blepharoptosis; (tarso) levator resection or advancement, internal 30-Sep-08 2
approach
67904 Repair of blepharoptosis; (tarso) levator resection or advancement, external 30-Sep-08 2
approach
67906 Repair of blepharoptosis; superior rectus technique with fascial sling (includes 30-Sep-08 2
obtaining fascia)
67908 Repair of blepharoptosis; conjunctivo-tarso-Muller's muscle-levator resection (eg, 30-Sep-08 2
Fasanella-Servat type)
67909 Reduction of overcorrection of ptosis 30-Sep-08 2
67911 Correction of lid retraction 30-Sep-08 4
67912 Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold 30-Sep-08 2
weight)
67914 Repair of ectropion; suture 30-Sep-08 4
67915 Repair of ectropion; thermocauterization 30-Sep-08 4
67916 Repair of ectropion; excision tarsal wedge 30-Sep-08 4
67917 Repair of ectropion; extensive (eg, tarsal strip operations) 30-Sep-08 4
67921 Repair of entropion; suture 30-Sep-08 4
67922 Repair of entropion; thermocauterization 30-Sep-08 4
67923 Repair of entropion; excision tarsal wedge 30-Sep-08 4
67924 Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs 30-Sep-08 4
operation)
67930 Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral 30-Sep-08 2
conjunctiva direct closure; partial thickness
67935 Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral 30-Sep-08 2
conjunctiva direct closure; full thickness
67938 Removal of embedded foreign body, eyelid 30-Sep-08 2
67950 Canthoplasty (reconstruction of canthus) 30-Sep-08 2
67961 Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, 30-Sep-08 4
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 Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, 30-Sep-08 4
or full thickness, may include preparation for skin graft or pedicle flap with
adjacent tissue transfer or rearrangement; over one-fourth of lid margin
67971 Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from 30-Sep-08 2
opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage
opposing eyelid; total eyelid, lower, 1 stage or first stage
opposing eyelid; total eyelid, upper, 1 stage or first stage
opposing eyelid; second stage
67999 Unlisted procedure, eyelids 30-Sep-08
68020 Incision of conjunctiva, drainage of cyst 30-Sep-08 2

68040 Expression of conjunctival follicles (eg, for trachoma) 30-Sep-08 2
68100 Biopsy of conjunctiva 30-Sep-08 2
68110 Excision of lesion, conjunctiva; up to 1 cm 30-Sep-08 2
68115 Excision of lesion, conjunctiva; over 1 cm 30-Sep-08 2
68130 Excision of lesion, conjunctiva; with adjacent sclera 30-Sep-08 2
68135 Destruction of lesion, conjunctiva 30-Sep-08 2
68200 Subconjunctival injection 30-Sep-08 2
68320 Conjunctivoplasty; with conjunctival graft or extensive rearrangement 30-Sep-08 2
68325 Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining 30-Sep-08 2
graft)
68326 Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive 30-Sep-08 2
rearrangement
68328 Conjunctivoplasty, reconstruction cul-de-sac; with buccal mucous membrane 30-Sep-08 2
68330 Repair of symblepharon; conjunctivoplasty, without graft 30-Sep-08 2
68335 Repair of symblepharon; with free graft conjunctiva or buccal mucous membrane 30-Sep-08 2
68340 Repair of symblepharon; division of symblepharon, with or without insertion of 30-Sep-08 2
conformer or contact lens
68360 Conjunctival flap; bridge or partial (separate procedure) 30-Sep-08 2
68362 Conjunctival flap; total (such as Gunderson thin flap or purse string flap) 30-Sep-08 2
68371 Harvesting conjunctival allograft, living donor 30-Sep-08 1

68399 Unlisted procedure, conjunctiva 30-Sep-08
68400 Incision, drainage of lacrimal gland 30-Sep-08 2

68420 Incision, drainage of lacrimal sac (dacryocystotomy or dacryocystostomy) 30-Sep-08 2
68440 Snip incision of lacrimal punctum 30-Sep-08 2

68500 Excision of lacrimal gland (dacryoadenectomy), except for tumor; total 30-Sep-08 2
68505 Excision of lacrimal gland (dacryoadenectomy), except for tumor; partial 30-Sep-08 2
68510 Biopsy of lacrimal gland 30-Sep-08 2

68520 Excision of lacrimal sac (dacryocystectomy) 30-Sep-08 2
68525 Biopsy of lacrimal sac 30-Sep-08 2
68530 Removal of foreign body or dacryolith, lacrimal passages 30-Sep-08 2
68540 Excision of lacrimal gland tumor; frontal approach 30-Sep-08 1
68550 Excision of lacrimal gland tumor; involving osteotomy 30-Sep-08 1
68700 Plastic repair of canaliculi 30-Sep-08 2
68705 Correction of everted punctum, cautery 30-Sep-08 2
68720 Dacryocystorhinostomy (fistulization of lacrimal sac to nasal cavity) 30-Sep-08 2
68745 Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); without tube 30-Sep-08 2
68750 Conjunctivorhinostomy (fistulization of conjunctiva to nasal cavity); with 30-Sep-08 2

insertion of tube or stent
68760 Closure of the lacrimal punctum; by thermocauterization, ligation, or laser 30-Sep-08 4
surgery
68761 Closure of the lacrimal punctum; by plug, each 30-Sep-08 4
68770 Closure of lacrimal fistula (separate procedure) 30-Sep-08 2
68801 Dilation of lacrimal punctum, with or without irrigation 30-Sep-08 4
68810 Probing of nasolacrimal duct, with or without irrigation; 30-Sep-08 1
68811 Probing of nasolacrimal duct, with or without irrigation; requiring general 30-Sep-08 1
anesthesia
68815 Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or 30-Sep-08 1
stent
68816 Probing of nasolacrimal duct, with or without irrigation; with transluminal balloon 30-Sep-08 1
catheter dilation
68840 Probing of lacrimal canaliculi, with or without irrigation 30-Sep-08 2
68850 Injection of contrast medium for dacryocystography 30-Sep-08 2
68899 Unlisted procedure, lacrimal system 30-Sep-08
69000 Drainage external ear, abscess or hematoma; simple 30-Sep-08 2

69005 Drainage external ear, abscess or hematoma; complicated 30-Sep-08 2
69020 Drainage external auditory canal, abscess 30-Sep-08 2
69090 Ear piercing 30-Sep-08
69100 Biopsy external ear 30-Sep-08 3

69105 Biopsy external auditory canal 30-Sep-08 2
69110 Excision external ear; partial, simple repair 30-Sep-08 2
69120 Excision external ear; complete amputation 30-Sep-08 1
69140 Excision exostosis(es), external auditory canal 30-Sep-08 2
69145 Excision soft tissue lesion, external auditory canal 30-Sep-08 2
69150 Radical excision external auditory canal lesion; without neck dissection 30-Sep-08 1
69155 Radical excision external auditory canal lesion; with neck dissection 30-Sep-08 1
69200 Removal foreign body from external auditory canal; without general anesthesia 30-Sep-08 2
69205 Removal foreign body from external auditory canal; with general anesthesia 30-Sep-08 2
69210 Removal impacted cerumen (separate procedure), 1 or both ears 30-Sep-08 1

69220 Debridement, mastoidectomy cavity, simple (eg, routine cleaning) 30-Sep-08 1
69222 Debridement, mastoidectomy cavity, complex (eg, with anesthesia or more than 30-Sep-08 1
routine cleaning)
69300 Otoplasty, protruding ear, with or without size reduction 30-Sep-08 1
69310 Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to 30-Sep-08 2
injury, infection) (separate procedure)
69320 Reconstruction external auditory canal for congenital atresia, single stage 30-Sep-08 2
69399 Unlisted procedure, external ear 30-Sep-08
69400 Eustachian tube inflation, transnasal; with catheterization 30-Sep-08 2

69401 Eustachian tube inflation, transnasal; without catheterization 30-Sep-08 2
69405 Eustachian tube catheterization, transtympanic 30-Sep-08 2
69420 Myringotomy including aspiration and/or eustachian tube inflation 30-Sep-08 2
69421 Myringotomy including aspiration and/or eustachian tube inflation requiring 30-Sep-08 2
general anesthesia
69424 Ventilating tube removal requiring general anesthesia 30-Sep-08 1
69433 Tympanostomy (requiring insertion of ventilating tube), local or topical 30-Sep-08 1
anesthesia
69436 Tympanostomy (requiring insertion of ventilating tube), general anesthesia 30-Sep-08 1
69440 Middle ear exploration through postauricular or ear canal incision 30-Sep-08 2
69450 Tympanolysis, transcanal 30-Sep-08 2
69501 Transmastoid antrotomy (simple mastoidectomy) 30-Sep-08 1
69502 Mastoidectomy; complete 30-Sep-08 1
69505 Mastoidectomy; modified radical 30-Sep-08 1
69511 Mastoidectomy; radical 30-Sep-08 1
69530 Petrous apicectomy including radical mastoidectomy 30-Sep-08 1
69535 Resection temporal bone, external approach 30-Sep-08 1
69540 Excision aural polyp 30-Sep-08 2
69550 Excision aural glomus tumor; transcanal 30-Sep-08 1
69552 Excision aural glomus tumor; transmastoid 30-Sep-08 1
69554 Excision aural glomus tumor; extended (extratemporal) 30-Sep-08 1
69601 Revision mastoidectomy; resulting in complete mastoidectomy 30-Sep-08 1
69602 Revision mastoidectomy; resulting in modified radical mastoidectomy 30-Sep-08 1
69603 Revision mastoidectomy; resulting in radical mastoidectomy 30-Sep-08 1

69604 Revision mastoidectomy; resulting in tympanoplasty 30-Sep-08 1
69605 Revision mastoidectomy; with apicectomy 30-Sep-08 1
69610 Tympanic membrane repair, with or without site preparation of perforation for 30-Sep-08 2
closure, with or without patch
69620 Myringoplasty (surgery confined to drumhead and donor area) 30-Sep-08 2
69631 Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or 30-Sep-08 2
middle ear surgery), initial or revision; without ossicular chain reconstruction

middle ear surgery), initial or revision; with ossicular chain reconstruction (eg,
postfenestration)
middle ear surgery), initial or revision; 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, 30-Sep-08 1

atticotomy, middle ear surgery, and/or tympanic membrane repair); without
ossicular chain reconstruction
atticotomy, middle ear surgery, and/or tympanic membrane repair); with
atticotomy, middle ear surgery, and/or tympanic membrane repair); 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, 30-Sep-08 1
tympanic membrane repair); without ossicular chain reconstruction
tympanic membrane repair); with ossicular chain reconstruction
tympanic membrane repair); with intact or reconstructed wall, without ossicular
chain reconstruction
tympanic membrane repair); with intact or reconstructed canal wall, with
tympanic membrane repair); radical or complete, without ossicular chain
reconstruction
tympanic membrane repair); radical or complete, with ossicular chain
reconstruction
69650 Stapes mobilization 30-Sep-08 1
69660 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with 30-Sep-08 1
or without use of foreign material;
69661 Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with 30-Sep-08 1
or without use of foreign material; with footplate drill out
69662 Revision of stapedectomy or stapedotomy 30-Sep-08 2

69666 Repair oval window fistula 30-Sep-08 2
69667 Repair round window fistula 30-Sep-08 2
69670 Mastoid obliteration (separate procedure) 30-Sep-08 1
69676 Tympanic neurectomy 30-Sep-08 1
69700 Closure postauricular fistula, mastoid (separate procedure) 30-Sep-08 2
69710 Implantation or replacement of electromagnetic bone conduction hearing device 30-Sep-08
in temporal bone
69711 Removal or repair of electromagnetic bone conduction hearing device in 30-Sep-08 2
temporal bone
69714 Implantation, osseointegrated implant, temporal bone, with percutaneous 30-Sep-08 2
attachment to external speech processor/cochlear stimulator; without
mastoidectomy
69715 Implantation, osseointegrated implant, temporal bone, with percutaneous 30-Sep-08 1
attachment to external speech processor/cochlear stimulator; with
mastoidectomy
69717 Replacement (including removal of existing device), osseointegrated implant, 30-Sep-08 1
temporal bone, with percutaneous attachment to external speech
processor/cochlear stimulator; without mastoidectomy
69718 Replacement (including removal of existing device), osseointegrated implant, 30-Sep-08 1
temporal bone, with percutaneous attachment to external speech
processor/cochlear stimulator; with mastoidectomy
69720 Decompression facial nerve, intratemporal; lateral to geniculate ganglion 30-Sep-08 2
69725 Decompression facial nerve, intratemporal; including medial to geniculate 30-Sep-08 2

ganglion
69740 Suture facial nerve, intratemporal, with or without graft or decompression; 30-Sep-08 2
lateral to geniculate ganglion
69745 Suture facial nerve, intratemporal, with or without graft or decompression; 30-Sep-08 2
including medial to geniculate ganglion
69799 Unlisted procedure, middle ear 30-Sep-08
69801 Labyrinthotomy, with perfusion of vestibuloactive drug(s); transcanal 30-Sep-08 1

69802 Labyrinthotomy, with perfusion of vestibuloactive drug(s); with mastoidectomy 30-Sep-08 1
69805 Endolymphatic sac operation; without shunt 30-Sep-08 1

69806 Endolymphatic sac operation; with shunt 30-Sep-08 1
69820 Fenestration semicircular canal 30-Sep-08 1
69840 Revision fenestration operation 30-Sep-08 1
69905 Labyrinthectomy; transcanal 30-Sep-08 1
69910 Labyrinthectomy; with mastoidectomy 30-Sep-08 1
69915 Vestibular nerve section, translabyrinthine approach 30-Sep-08 1
69930 Cochlear device implantation, with or without mastoidectomy 30-Sep-08 2
69949 Unlisted procedure, inner ear 30-Sep-08
69950 Vestibular nerve section, transcranial approach 30-Sep-08 2

69955 Total facial nerve decompression and/or repair (may include graft) 30-Sep-08 2
69960 Decompression internal auditory canal 30-Sep-08 2
69970 Removal of tumor, temporal bone 30-Sep-08 1
69979 Unlisted procedure, temporal bone, middle fossa approach 30-Sep-08
69990 Microsurgical techniques, requiring use of operating microscope (List separately 30-Sep-08 1
70010 Myelography, posterior fossa, radiological supervision and interpretation 30-Sep-08 1
70015 Cisternography, positive contrast, radiological supervision and interpretation 30-Sep-08 1
70030 Radiologic examination, eye, for detection of foreign body 30-Sep-08 2

70100 Radiologic examination, mandible; partial, less than 4 views 30-Sep-08 1
70110 Radiologic examination, mandible; complete, minimum of 4 views 30-Sep-08 1
70120 Radiologic examination, mastoids; less than 3 views per side 30-Sep-08 2
70130 Radiologic examination, mastoids; complete, minimum of 3 views per side 30-Sep-08 2
70134 Radiologic examination, internal auditory meati, complete 30-Sep-08 1

70140 Radiologic examination, facial bones; less than 3 views 30-Sep-08 1
70150 Radiologic examination, facial bones; complete, minimum of 3 views 30-Sep-08 1
70160 Radiologic examination, nasal bones, complete, minimum of 3 views 30-Sep-08 1
70170 Dacryocystography, nasolacrimal duct, radiological supervision and 30-Sep-08 2
interpretation
70190 Radiologic examination; optic foramina 30-Sep-08 1
70200 Radiologic examination; orbits, complete, minimum of 4 views 30-Sep-08 1
70210 Radiologic examination, sinuses, paranasal, less than 3 views 30-Sep-08 1
70220 Radiologic examination, sinuses, paranasal, complete, minimum of 3 views 30-Sep-08 1
70240 Radiologic examination, sella turcica 30-Sep-08 1

70250 Radiologic examination, skull; less than 4 views 30-Sep-08 1
70260 Radiologic examination, skull; complete, minimum of 4 views 30-Sep-08 1
70300 Radiologic examination, teeth; single view 30-Sep-08 1
70310 Radiologic examination, teeth; partial examination, less than full mouth 30-Sep-08 1
70320 Radiologic examination, teeth; complete, full mouth 30-Sep-08 1
70328 Radiologic examination, temporomandibular joint, open and closed mouth; 30-Sep-08 1
unilateral
70330 Radiologic examination, temporomandibular joint, open and closed mouth; 30-Sep-08 1
bilateral
70332 Temporomandibular joint arthrography, radiological supervision and 30-Sep-08 2
interpretation
70336 Magnetic resonance (eg, proton) imaging, temporomandibular joint(s) 30-Sep-08 1
70350 Cephalogram, orthodontic 30-Sep-08 1
70355 Orthopantogram 30-Sep-08 1
70360 Radiologic examination; neck, soft tissue 30-Sep-08 1

70370 Radiologic examination; pharynx or larynx, including fluoroscopy and/or 30-Sep-08 1
magnification technique
70371 Complex dynamic pharyngeal and speech evaluation by cine or video recording 30-Sep-08 1
70373 Laryngography, contrast, radiological supervision and interpretation 30-Sep-08 1

70380 Radiologic examination, salivary gland for calculus 30-Sep-08 2
70390 Sialography, radiological supervision and interpretation 30-Sep-08 2
70450 Computed tomography, head or brain; without contrast material 30-Sep-08 3
70460 Computed tomography, head or brain; with contrast material(s) 30-Sep-08 1
70470 Computed tomography, head or brain; without contrast material, followed by 30-Sep-08 2
contrast material(s) and further sections
70480 Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner 30-Sep-08 1
ear; without contrast material
ear; with contrast material(s)
ear; without contrast material, followed by contrast material(s) and further
sections
70486 Computed tomography, maxillofacial area; without contrast material 30-Sep-08 1
70487 Computed tomography, maxillofacial area; with contrast material(s) 30-Sep-08 1
70488 Computed tomography, maxillofacial area; without contrast material, followed 30-Sep-08 1
by contrast material(s) and further sections
70490 Computed tomography, soft tissue neck; without contrast material 30-Sep-08 1
70491 Computed tomography, soft tissue neck; with contrast material(s) 30-Sep-08 1
70492 Computed tomography, soft tissue neck; without contrast material followed by 30-Sep-08 1
70496 Computed tomographic angiography, head, with contrast material(s), including 30-Sep-08 1
noncontrast images, if performed, and image postprocessing
70498 Computed tomographic angiography, neck, with contrast material(s), including 30-Sep-08 1
70540 Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without 30-Sep-08 1
contrast material(s)
70542 Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast 30-Sep-08 1
material(s)
70543 Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without 30-Sep-08 1
contrast material(s), followed by contrast material(s) and further sequences
70544 Magnetic resonance angiography, head; without contrast material(s) 30-Sep-08 1

70545 Magnetic resonance angiography, head; with contrast material(s) 30-Sep-08 1
70546 Magnetic resonance angiography, head; without contrast material(s), followed 30-Sep-08 1
by contrast material(s) and further sequences
70547 Magnetic resonance angiography, neck; without contrast material(s) 30-Sep-08 1
70548 Magnetic resonance angiography, neck; with contrast material(s) 30-Sep-08 1
70549 Magnetic resonance angiography, neck; without contrast material(s), followed by 30-Sep-08 1
contrast material(s) and further sequences
70551 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without 30-Sep-08 1
contrast material
70552 Magnetic resonance (eg, proton) imaging, brain (including brain stem); with 30-Sep-08 1
70553 Magnetic resonance (eg, proton) imaging, brain (including brain stem); without 30-Sep-08 1
contrast material, followed by contrast material(s) and further sequences
70554 Magnetic resonance imaging, brain, functional MRI; including test selection and 30-Sep-08 1
administration of repetitive body part movement and/or visual stimulation, not
requiring physician or psychologist administration
70555 Magnetic resonance imaging, brain, functional MRI; requiring physician or 30-Sep-08 1
psychologist administration of entire neurofunctional testing
70557 Magnetic resonance (eg, proton) imaging, brain (including brain stem and skull 30-Sep-08 1
base), during open intracranial procedure (eg, to assess for residual tumor or
residual vascular malformation); without contrast material
residual vascular malformation); with contrast material(s)
residual vascular malformation); without contrast material(s), followed by
71010 Radiologic examination, chest; single view, frontal 30-Sep-08
71015 Radiologic examination, chest; stereo, frontal 30-Sep-08 2
71020 Radiologic examination, chest, 2 views, frontal and lateral; 30-Sep-08
71021 Radiologic examination, chest, 2 views, frontal and lateral; with apical lordotic 30-Sep-08 1
procedure
71022 Radiologic examination, chest, 2 views, frontal and lateral; with oblique 30-Sep-08 1
projections
71023 Radiologic examination, chest, 2 views, frontal and lateral; with fluoroscopy 30-Sep-08 2
71030 Radiologic examination, chest, complete, minimum of 4 views; 30-Sep-08 2

71034 Radiologic examination, chest, complete, minimum of 4 views; with fluoroscopy 30-Sep-08 1
71035 Radiologic examination, chest, special views (eg, lateral decubitus, Bucky 30-Sep-08 2
studies)
71040 Bronchography, unilateral, radiological supervision and interpretation 30-Sep-08 1
71060 Bronchography, bilateral, radiological supervision and interpretation 30-Sep-08 1
71090 Insertion pacemaker, fluoroscopy and radiography, radiological supervision and 30-Sep-08 1
interpretation
71100 Radiologic examination, ribs, unilateral; 2 views 30-Sep-08 1
71101 Radiologic examination, ribs, unilateral; including posteroanterior chest, 30-Sep-08 1
minimum of 3 views
71110 Radiologic examination, ribs, bilateral; 3 views 30-Sep-08 1
71111 Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum 30-Sep-08 1
of 4 views
71120 Radiologic examination; sternum, minimum of 2 views 30-Sep-08 1
71130 Radiologic examination; sternoclavicular joint or joints, minimum of 3 views 30-Sep-08 1
71250 Computed tomography, thorax; without contrast material 30-Sep-08 1

71260 Computed tomography, thorax; with contrast material(s) 30-Sep-08 1
71270 Computed tomography, thorax; without contrast material, followed by contrast 30-Sep-08 1
material(s) and further sections
71275 Computed tomographic angiography, chest (noncoronary), with contrast 30-Sep-08 1
material(s), including noncontrast images, if performed, and image
postprocessing
71550 Magnetic resonance (eg, proton) imaging, chest (eg, for evaluation of hilar and 30-Sep-08 1
mediastinal lymphadenopathy); without contrast material(s)
mediastinal lymphadenopathy); with contrast material(s)
mediastinal lymphadenopathy); without contrast material(s), followed by
71555 Magnetic resonance angiography, chest (excluding myocardium), with or without 30-Sep-08 1
72010 Radiologic examination, spine, entire, survey study, anteroposterior and lateral 30-Sep-08 1
72020 Radiologic examination, spine, single view, specify level 30-Sep-08 4

72040 Radiologic examination, spine, cervical; 2 or 3 views 30-Sep-08 3
72050 Radiologic examination, spine, cervical; minimum of 4 views 30-Sep-08 1
72052 Radiologic examination, spine, cervical; complete, including oblique and flexion 30-Sep-08 1
and/or extension studies
72069 Radiologic examination, spine, thoracolumbar, standing (scoliosis) 30-Sep-08 1
72070 Radiologic examination, spine; thoracic, 2 views 30-Sep-08 1
72072 Radiologic examination, spine; thoracic, 3 views 30-Sep-08 1
72074 Radiologic examination, spine; thoracic, minimum of 4 views 30-Sep-08 1
72080 Radiologic examination, spine; thoracolumbar, 2 views 30-Sep-08 1
72090 Radiologic examination, spine; scoliosis study, including supine and erect studies 30-Sep-08 1
72100 Radiologic examination, spine, lumbosacral; 2 or 3 views 30-Sep-08 1

72110 Radiologic examination, spine, lumbosacral; minimum of 4 views 30-Sep-08 1
72114 Radiologic examination, spine, lumbosacral; complete, including bending views 30-Sep-08 1
72120 Radiologic examination, spine, lumbosacral, bending views only, minimum of 4 30-Sep-08 1
views
72125 Computed tomography, cervical spine; without contrast material 30-Sep-08 1
72126 Computed tomography, cervical spine; with contrast material 30-Sep-08 1
72127 Computed tomography, cervical spine; without contrast material, followed by 30-Sep-08 1
72128 Computed tomography, thoracic spine; without contrast material 30-Sep-08 1
72129 Computed tomography, thoracic spine; with contrast material 30-Sep-08 1
72130 Computed tomography, thoracic spine; without contrast material, followed by 30-Sep-08 1
72131 Computed tomography, lumbar spine; without contrast material 30-Sep-08 1
72132 Computed tomography, lumbar spine; with contrast material 30-Sep-08 1
72133 Computed tomography, lumbar spine; without contrast material, followed by 30-Sep-08 1
72141 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; 30-Sep-08 1
without contrast material
72142 Magnetic resonance (eg, proton) imaging, spinal canal and contents, cervical; 30-Sep-08 1
with contrast material(s)
72146 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; 30-Sep-08 1
72147 Magnetic resonance (eg, proton) imaging, spinal canal and contents, thoracic; 30-Sep-08 1
72148 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; 30-Sep-08 1
72149 Magnetic resonance (eg, proton) imaging, spinal canal and contents, lumbar; 30-Sep-08 1
72156 Magnetic resonance (eg, proton) imaging, spinal canal and contents, without 30-Sep-08 1
contrast material, followed by contrast material(s) and further sequences;
cervical
thoracic
lumbar
72159 Magnetic resonance angiography, spinal canal and contents, with or without 30-Sep-08
72170 Radiologic examination, pelvis; 1 or 2 views 30-Sep-08 1
72190 Radiologic examination, pelvis; complete, minimum of 3 views 30-Sep-08 1
72191 Computed tomographic angiography, pelvis, with contrast material(s), including 30-Sep-08 1
72192 Computed tomography, pelvis; without contrast material 30-Sep-08 1

72193 Computed tomography, pelvis; with contrast material(s) 30-Sep-08 1
72194 Computed tomography, pelvis; without contrast material, followed by contrast 30-Sep-08 1
material(s) and further sections
72195 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s) 30-Sep-08 1
72196 Magnetic resonance (eg, proton) imaging, pelvis; with contrast material(s) 30-Sep-08 1
72197 Magnetic resonance (eg, proton) imaging, pelvis; without contrast material(s), 30-Sep-08 1
followed by contrast material(s) and further sequences
72198 Magnetic resonance angiography, pelvis, with or without contrast material(s) 30-Sep-08 1
72200 Radiologic examination, sacroiliac joints; less than 3 views 30-Sep-08 1

72202 Radiologic examination, sacroiliac joints; 3 or more views 30-Sep-08 1
72220 Radiologic examination, sacrum and coccyx, minimum of 2 views 30-Sep-08 1
72240 Myelography, cervical, radiological supervision and interpretation 30-Sep-08 1
72255 Myelography, thoracic, radiological supervision and interpretation 30-Sep-08 1
72265 Myelography, lumbosacral, radiological supervision and interpretation 30-Sep-08 1
72270 Myelography, 2 or more regions (eg, lumbar/thoracic, cervical/thoracic, 30-Sep-08 1

lumbar/cervical, lumbar/thoracic/cervical), radiological supervision and
interpretation
72275 Epidurography, radiological supervision and interpretation 30-Sep-08 3
72285 Discography, cervical or thoracic, radiological supervision and interpretation 30-Sep-08
72291 Radiological supervision and interpretation, percutaneous vertebroplasty, 30-Sep-08

vertebral augmentation, or sacral augmentation (sacroplasty), including cavity
creation, per vertebral body or sacrum; under fluoroscopic guidance
72292 Radiological supervision and interpretation, percutaneous vertebroplasty, 30-Sep-08 3

vertebral augmentation, or sacral augmentation (sacroplasty), including cavity
creation, per vertebral body or sacrum; under CT guidance
72295 Discography, lumbar, radiological supervision and interpretation 30-Sep-08

73000 Radiologic examination; clavicle, complete 30-Sep-08 2
73010 Radiologic examination; scapula, complete 30-Sep-08 2
73020 Radiologic examination, shoulder; 1 view 30-Sep-08 2
73030 Radiologic examination, shoulder; complete, minimum of 2 views 30-Sep-08 2
73040 Radiologic examination, shoulder, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73050 Radiologic examination; acromioclavicular joints, bilateral, with or without 30-Sep-08 1
weighted distraction
73060 Radiologic examination; humerus, minimum of 2 views 30-Sep-08 2
73070 Radiologic examination, elbow; 2 views 30-Sep-08 2
73080 Radiologic examination, elbow; complete, minimum of 3 views 30-Sep-08 2
73085 Radiologic examination, elbow, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73090 Radiologic examination; forearm, 2 views 30-Sep-08 2
73092 Radiologic examination; upper extremity, infant, minimum of 2 views 30-Sep-08 2
73100 Radiologic examination, wrist; 2 views 30-Sep-08 2
73110 Radiologic examination, wrist; complete, minimum of 3 views 30-Sep-08 2
73115 Radiologic examination, wrist, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73120 Radiologic examination, hand; 2 views 30-Sep-08 2
73130 Radiologic examination, hand; minimum of 3 views 30-Sep-08 2
73140 Radiologic examination, finger(s), minimum of 2 views 30-Sep-08 2
73200 Computed tomography, upper extremity; without contrast material 30-Sep-08 2
73201 Computed tomography, upper extremity; with contrast material(s) 30-Sep-08 2
73202 Computed tomography, upper extremity; without contrast material, followed by 30-Sep-08 2
73206 Computed tomographic angiography, upper extremity, with contrast material(s), 30-Sep-08 2
including noncontrast images, if performed, and image postprocessing
73218 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; 30-Sep-08 2
without contrast material(s)
73219 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with 30-Sep-08 2
73220 Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; 30-Sep-08 2
without contrast material(s), followed by contrast material(s) and further
sequences
73221 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without 30-Sep-08 2
73222 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with 30-Sep-08 2
73223 Magnetic resonance (eg, proton) imaging, any joint of upper extremity; without 30-Sep-08 2
73225 Magnetic resonance angiography, upper extremity, with or without contrast 30-Sep-08
material(s)
73500 Radiologic examination, hip, unilateral; 1 view 30-Sep-08 2
73510 Radiologic examination, hip, unilateral; complete, minimum of 2 views 30-Sep-08 2
73520 Radiologic examination, hips, bilateral, minimum of 2 views of each hip, 30-Sep-08 2
including anteroposterior view of pelvis
73525 Radiologic examination, hip, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73530 Radiologic examination, hip, during operative procedure 30-Sep-08 2
73540 Radiologic examination, pelvis and hips, infant or child, minimum of 2 views 30-Sep-08 1
73542 Radiological examination, sacroiliac joint arthrography, radiological supervision 30-Sep-08 2

and interpretation
73550 Radiologic examination, femur, 2 views 30-Sep-08 2
73560 Radiologic examination, knee; 1 or 2 views 30-Sep-08 2
73562 Radiologic examination, knee; 3 views 30-Sep-08 2
73564 Radiologic examination, knee; complete, 4 or more views 30-Sep-08 2
73565 Radiologic examination, knee; both knees, standing, anteroposterior 30-Sep-08 1
73580 Radiologic examination, knee, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73590 Radiologic examination; tibia and fibula, 2 views 30-Sep-08 2
73592 Radiologic examination; lower extremity, infant, minimum of 2 views 30-Sep-08 2
73600 Radiologic examination, ankle; 2 views 30-Sep-08 2
73610 Radiologic examination, ankle; complete, minimum of 3 views 30-Sep-08 2
73615 Radiologic examination, ankle, arthrography, radiological supervision and 30-Sep-08 2
interpretation
73620 Radiologic examination, foot; 2 views 30-Sep-08 2
73630 Radiologic examination, foot; complete, minimum of 3 views 30-Sep-08 2
73650 Radiologic examination; calcaneus, minimum of 2 views 30-Sep-08 2
73660 Radiologic examination; toe(s), minimum of 2 views 30-Sep-08 2
73700 Computed tomography, lower extremity; without contrast material 30-Sep-08 2
73701 Computed tomography, lower extremity; with contrast material(s) 30-Sep-08 2
73702 Computed tomography, lower extremity; without contrast material, followed by 30-Sep-08 2
73706 Computed tomographic angiography, lower extremity, with contrast material(s), 30-Sep-08 2
73718 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; 30-Sep-08 2
without contrast material(s)
73719 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with 30-Sep-08 2
73720 Magnetic resonance (eg, proton) imaging, lower extremity other than joint; 30-Sep-08 2
without contrast material(s), followed by contrast material(s) and further
sequences
73721 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without 30-Sep-08 4
contrast material
73722 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; with 30-Sep-08 2
73723 Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without 30-Sep-08 4
73725 Magnetic resonance angiography, lower extremity, with or without contrast 30-Sep-08 2
material(s)
74000 Radiologic examination, abdomen; single anteroposterior view 30-Sep-08 3
74010 Radiologic examination, abdomen; anteroposterior and additional oblique and 30-Sep-08 2
cone views
74020 Radiologic examination, abdomen; complete, including decubitus and/or erect 30-Sep-08 2
views
74022 Radiologic examination, abdomen; complete acute abdomen series, including 30-Sep-08 2
supine, erect, and/or decubitus views, single view chest
74150 Computed tomography, abdomen; without contrast material 30-Sep-08 1
74160 Computed tomography, abdomen; with contrast material(s) 30-Sep-08 1
74170 Computed tomography, abdomen; without contrast material, followed by 30-Sep-08 1
74175 Computed tomographic angiography, abdomen, with contrast material(s), 30-Sep-08 1
74176 Computed tomography, abdomen and pelvis; without contrast material 15-Oct-12 1
74177 Computed tomography, abdomen and pelvis; with contrast material(s) 15-Oct-12 1
74178 Computed tomography, abdomen and pelvis; without contrast material in one or 15-Oct-12 1
both body regions, followed by contrast material(s) and further sections in one
or both body regions
74181 Magnetic resonance (eg, proton) imaging, abdomen; without contrast material(s) 30-Sep-08 1
74182 Magnetic resonance (eg, proton) imaging, abdomen; with contrast material(s) 30-Sep-08 1
74183 Magnetic resonance (eg, proton) imaging, abdomen; without contrast 30-Sep-08 1
material(s), followed by with contrast material(s) and further sequences
74185 Magnetic resonance angiography, abdomen, with or without contrast material(s) 30-Sep-08 1
74190 Peritoneogram (eg, after injection of air or contrast), radiological supervision and 30-Sep-08 1
interpretation
74210 Radiologic examination; pharynx and/or cervical esophagus 30-Sep-08 1
74220 Radiologic examination; esophagus 30-Sep-08 1
74230 Swallowing function, with cineradiography/videoradiography 30-Sep-08 1
74235 Removal of foreign body(s), esophageal, with use of balloon catheter, 30-Sep-08 1
74240 Radiologic examination, gastrointestinal tract, upper; with or without delayed 30-Sep-08 1
films, without KUB
74241 Radiologic examination, gastrointestinal tract, upper; with or without delayed 30-Sep-08 1
films, with KUB
74245 Radiologic examination, gastrointestinal tract, upper; with small intestine, 30-Sep-08 1
includes multiple serial films
74246 Radiological examination, gastrointestinal tract, upper, air contrast, with specific 30-Sep-08 1
high density barium, effervescent agent, with or without glucagon; with or
without delayed films, without KUB
high density barium, effervescent agent, with or without glucagon; with or
without delayed films, with KUB
high density barium, effervescent agent, with or without glucagon; with small
intestine follow-through
74250 Radiologic examination, small intestine, includes multiple serial films; 30-Sep-08 1
74251 Radiologic examination, small intestine, includes multiple serial films; via 30-Sep-08 1
enteroclysis tube
74260 Duodenography, hypotonic 30-Sep-08 1
74261 Computed tomographic (CT) colonography, diagnostic, including image 15-Oct-12
postprocessing; without contrast material
74262 Computed tomographic (CT) colonography, diagnostic, including image 15-Oct-12
postprocessing; with contrast material(s) including non-contrast images, if
performed
74263 Computed tomographic (CT) colonography, screening, including image 15-Oct-12
postprocessing
74270 Radiologic examination, colon; contrast (eg, barium) enema, with or without KUB 30-Sep-08 1
74280 Radiologic examination, colon; air contrast with specific high density barium, 30-Sep-08 1
with or without glucagon
74283 Therapeutic enema, contrast or air, for reduction of intussusception or other 30-Sep-08 1
intraluminal obstruction (eg, meconium ileus)
74290 Cholecystography, oral contrast; 30-Sep-08 1
74291 Cholecystography, oral contrast; additional or repeat examination or multiple 30-Sep-08 1
day examination
74300 Cholangiography and/or pancreatography; intraoperative, radiological 30-Sep-08 1
supervision and interpretation
74301 Cholangiography and/or pancreatography; additional set intraoperative, 30-Sep-08 2
radiological supervision and interpretation (List separately in addition to code for
primary procedure)
74305 Cholangiography and/or pancreatography; through existing catheter, radiological 30-Sep-08 1
74320 Cholangiography, percutaneous, transhepatic, radiological supervision and 30-Sep-08 1
interpretation
74327 Postoperative biliary duct calculus removal, percutaneous via T-tube tract, 30-Sep-08 1
basket, or snare (eg, Burhenne technique), radiological supervision and
interpretation
74328 Endoscopic catheterization of the biliary ductal system, radiological supervision 30-Sep-08 1
and interpretation
74329 Endoscopic catheterization of the pancreatic ductal system, radiological 30-Sep-08 1
74330 Combined endoscopic catheterization of the biliary and pancreatic ductal 30-Sep-08 1
systems, radiological supervision and interpretation
74340 Introduction of long gastrointestinal tube (eg, Miller-Abbott), including multiple 30-Sep-08 1
fluoroscopies and films, radiological supervision and interpretation
74355 Percutaneous placement of enteroclysis tube, radiological supervision and 30-Sep-08 1

interpretation
74360 Intraluminal dilation of strictures and/or obstructions (eg, esophagus), 30-Sep-08 1
74363 Percutaneous transhepatic dilation of biliary duct stricture with or without 30-Sep-08 2
placement of stent, radiological supervision and interpretation
74400 Urography (pyelography), intravenous, with or without KUB, with or without 30-Sep-08 1
tomography
74410 Urography, infusion, drip technique and/or bolus technique; 30-Sep-08 1
74415 Urography, infusion, drip technique and/or bolus technique; with 30-Sep-08 1
nephrotomography
74420 Urography, retrograde, with or without KUB 30-Sep-08 2
74425 Urography, antegrade (pyelostogram, nephrostogram, loopogram), radiological 30-Sep-08 2
74430 Cystography, minimum of 3 views, radiological supervision and interpretation 30-Sep-08 1
74440 Vasography, vesiculography, or epididymography, radiological supervision and 30-Sep-08 2

interpretation
74445 Corpora cavernosography, radiological supervision and interpretation 30-Sep-08 1
74450 Urethrocystography, retrograde, radiological supervision and interpretation 30-Sep-08 1
74455 Urethrocystography, voiding, radiological supervision and interpretation 30-Sep-08 1
74470 Radiologic examination, renal cyst study, translumbar, contrast visualization, 30-Sep-08 2
74475 Introduction of intracatheter or catheter into renal pelvis for drainage and/or 30-Sep-08 2
injection, percutaneous, radiological supervision and interpretation
74480 Introduction of ureteral catheter or stent into ureter through renal pelvis for 30-Sep-08 2
drainage and/or injection, percutaneous, radiological supervision and
interpretation
74485 Dilation of nephrostomy, ureters, or urethra, radiological supervision and 30-Sep-08 2
interpretation
74710 Pelvimetry, with or without placental localization 30-Sep-08 1
74740 Hysterosalpingography, radiological supervision and interpretation 30-Sep-08 1
74742 Transcervical catheterization of fallopian tube, radiological supervision and 30-Sep-08 2
interpretation
74775 Perineogram (eg, vaginogram, for sex determination or extent of anomalies) 30-Sep-08 1
75557 Cardiac magnetic resonance imaging for morphology and function without 30-Sep-08 1
contrast material;
75558 Cardiac magnetic resonance imaging for morphology and function without 30-Sep-08 14-Oct-12
contrast material; with flow/velocity quantification
contrast material; with stress imaging
contrast material; with flow/velocity quantification and stress
contrast material(s), followed by contrast material(s) and further sequences;
with flow/velocity quantification
with stress imaging
with flow/velocity quantification and stress
75565 Cardiac magnetic resonance imaging for velocity flow mapping (List separately 15-Oct-12
75571 Computed tomography, heart, without contrast material, with quantitative 15-Oct-12
evaluation of coronary calcium
75572 Computed tomography, heart, with contrast material, for evaluation of cardiac 15-Oct-12
structure and morphology (including 3D image postprocessing, assessment of
cardiac function, and evaluation of venous structures, if performed)
75573 Computed tomography, heart, with contrast material, for evaluation of cardiac 15-Oct-12
structure and morphology in the setting of congenital heart disease (including
3D image postprocessing, assessment of LV cardiac function, RV structure and
function and evaluation of venous structures, if performed)
75574 Computed tomographic angiography, heart, coronary arteries and bypass grafts 15-Oct-12
(when present), with contrast material, including 3D image postprocessing
(including evaluation of cardiac structure and morphology, assessment of
cardiac function, and evaluation of venous structures, if performed)
75600 Aortography, thoracic, without serialography, radiological supervision and 30-Sep-08 1

interpretation
75605 Aortography, thoracic, by serialography, radiological supervision and 30-Sep-08 1
interpretation
75625 Aortography, abdominal, by serialography, radiological supervision and 30-Sep-08 1
interpretation
75630 Aortography, abdominal plus bilateral iliofemoral lower extremity, catheter, by 30-Sep-08 1
serialography, radiological supervision and interpretation
75635 Computed tomographic angiography, abdominal aorta and bilateral iliofemoral 30-Sep-08 1
lower extremity runoff, with contrast material(s), including noncontrast images,
if performed, and image postprocessing
75650 Angiography, cervicocerebral, catheter, including vessel origin, radiological 30-Sep-08 2

75658 Angiography, brachial, retrograde, radiological supervision and interpretation 30-Sep-08 2
75660 Angiography, external carotid, unilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75662 Angiography, external carotid, bilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75665 Angiography, carotid, cerebral, unilateral, radiological supervision and 30-Sep-08 1
interpretation
75671 Angiography, carotid, cerebral, bilateral, radiological supervision and 30-Sep-08 1
interpretation
75676 Angiography, carotid, cervical, unilateral, radiological supervision and 30-Sep-08 1
interpretation
75680 Angiography, carotid, cervical, bilateral, radiological supervision and 30-Sep-08 1
interpretation
75685 Angiography, vertebral, cervical, and/or intracranial, radiological supervision and 30-Sep-08 2
interpretation
75705 Angiography, spinal, selective, radiological supervision and interpretation 30-Sep-08
75710 Angiography, extremity, unilateral, radiological supervision and interpretation 30-Sep-08 1
75716 Angiography, extremity, bilateral, radiological supervision and interpretation 30-Sep-08 1
75722 Angiography, renal, unilateral, selective (including flush aortogram), radiological 30-Sep-08 1
75724 Angiography, renal, bilateral, selective (including flush aortogram), radiological 30-Sep-08 1
75726 Angiography, visceral, selective or supraselective (with or without flush 30-Sep-08 3
aortogram), radiological supervision and interpretation
75731 Angiography, adrenal, unilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75733 Angiography, adrenal, bilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75736 Angiography, pelvic, selective or supraselective, radiological supervision and 30-Sep-08 2
interpretation
75741 Angiography, pulmonary, unilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75743 Angiography, pulmonary, bilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75746 Angiography, pulmonary, by nonselective catheter or venous injection, 30-Sep-08 1
75756 Angiography, internal mammary, radiological supervision and interpretation 30-Sep-08 2
75774 Angiography, selective, each additional vessel studied after basic examination, 30-Sep-08
primary procedure)
75790 Angiography, arteriovenous shunt (eg, dialysis patient), radiological supervision 30-Sep-08 14-Oct-12
and interpretation
75791 Angiography, arteriovenous shunt (eg, dialysis patient fistula/graft), complete 15-Oct-12
evaluation of dialysis access, including fluoroscopy, image documentation and
report (includes injections of contrast and all necessary imaging from the arterial
anastomosis and adjacent artery through entire venous outflow including the
inferior or superior vena cava), radiological supervision and interpretation
75801 Lymphangiography, extremity only, unilateral, radiological supervision and 30-Sep-08 1

interpretation
75803 Lymphangiography, extremity only, bilateral, radiological supervision and 30-Sep-08 1
interpretation
75805 Lymphangiography, pelvic/abdominal, unilateral, radiological supervision and 30-Sep-08 1
interpretation
75807 Lymphangiography, pelvic/abdominal, bilateral, radiological supervision and 30-Sep-08 1
interpretation
75809 Shuntogram for investigation of previously placed indwelling nonvascular shunt 30-Sep-08 1
(eg, LeVeen shunt, ventriculoperitoneal shunt, indwelling infusion pump),
75810 Splenoportography, radiological supervision and interpretation 30-Sep-08 1

75820 Venography, extremity, unilateral, radiological supervision and interpretation 30-Sep-08 1
75822 Venography, extremity, bilateral, radiological supervision and interpretation 30-Sep-08 1
75825 Venography, caval, inferior, with serialography, radiological supervision and 30-Sep-08 1
interpretation
75827 Venography, caval, superior, with serialography, radiological supervision and 30-Sep-08 1
interpretation
75831 Venography, renal, unilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75833 Venography, renal, bilateral, selective, radiological supervision and interpretation 30-Sep-08 1
75840 Venography, adrenal, unilateral, selective, radiological supervision and 30-Sep-08 1

interpretation
75842 Venography, adrenal, bilateral, selective, radiological supervision and 30-Sep-08 1
interpretation
75860 Venography, venous sinus (eg, petrosal and inferior sagittal) or jugular, catheter, 30-Sep-08 2
75870 Venography, superior sagittal sinus, radiological supervision and interpretation 30-Sep-08 1
75872 Venography, epidural, radiological supervision and interpretation 30-Sep-08 1

75880 Venography, orbital, radiological supervision and interpretation 30-Sep-08 2
75885 Percutaneous transhepatic portography with hemodynamic evaluation, 30-Sep-08 1
75887 Percutaneous transhepatic portography without hemodynamic evaluation, 30-Sep-08 1
75889 Hepatic venography, wedged or free, with hemodynamic evaluation, radiological 30-Sep-08 1
75891 Hepatic venography, wedged or free, without hemodynamic evaluation, 30-Sep-08 1
75893 Venous sampling through catheter, with or without angiography (eg, for 30-Sep-08
parathyroid hormone, renin), radiological supervision and interpretation
75894 Transcatheter therapy, embolization, any method, radiological supervision and 30-Sep-08
interpretation
75896 Transcatheter therapy, infusion, any method (eg, thrombolysis other than 30-Sep-08
coronary), radiological supervision and interpretation
75898 Angiography through existing catheter for follow-up study for transcatheter 30-Sep-08
therapy, embolization or infusion
75900 Exchange of a previously placed intravascular catheter during thrombolytic 30-Sep-08 3
therapy with contrast monitoring, radiological supervision and interpretation
75901 Mechanical removal of pericatheter obstructive material (eg, fibrin sheath) from 30-Sep-08 1
central venous device via separate venous access, radiologic supervision and
interpretation
75902 Mechanical removal of intraluminal (intracatheter) obstructive material from 30-Sep-08 2
central venous device through device lumen, radiologic supervision and
interpretation
75940 Percutaneous placement of IVC filter, radiological supervision and interpretation 30-Sep-08 1
75945 Intravascular ultrasound (non-coronary vessel), radiological supervision and 30-Sep-08 1

interpretation; initial vessel
75946 Intravascular ultrasound (non-coronary vessel), radiological supervision and 30-Sep-08
interpretation; each additional non-coronary vessel (List separately in addition to
75952 Endovascular repair of infrarenal abdominal aortic aneurysm or dissection, 30-Sep-08 1
infrarenal aortic or iliac artery aneurysm, pseudoaneurysm, or dissection,
75954 Endovascular repair of iliac artery aneurysm, pseudoaneurysm, arteriovenous 30-Sep-08 2
malformation, or trauma, using ilio-iliac tube endoprosthesis, radiological
traumatic disruption); involving coverage of left subclavian artery origin, initial
endoprosthesis plus descending thoracic aortic extension(s), if required, to level
of celiac artery origin, radiological supervision and interpretation

traumatic disruption); not involving coverage of left subclavian artery origin,
initial endoprosthesis plus descending thoracic aortic extension(s), if required, to
level of celiac artery origin, radiological supervision and interpretation

penetrating ulcer, intramural hematoma, or traumatic disruption), radiological
75959 Placement of distal extension prosthesis(s) (delayed) after endovascular repair 30-Sep-08 1
of descending thoracic aorta, as needed, to level of celiac origin, radiological
75960 Transcatheter introduction of intravascular stent(s) (except coronary, carotid, 30-Sep-08
vertebral, iliac, and lower extremity artery), percutaneous and/or open,
radiological supervision and interpretation, each vessel
75961 Transcatheter retrieval, percutaneous, of intravascular foreign body (eg, 30-Sep-08 2
fractured venous or arterial catheter), radiological supervision and interpretation
75962 Transluminal balloon angioplasty, peripheral artery other than cervical carotid, 30-Sep-08 1
renal or other visceral artery, iliac or lower extremity, radiological supervision
and interpretation
75964 Transluminal balloon angioplasty, each additional peripheral artery other than 30-Sep-08 4
cervical carotid, renal or other visceral artery, iliac and lower extremity,
primary procedure)
75966 Transluminal balloon angioplasty, renal or other visceral artery, radiological 30-Sep-08 1
75968 Transluminal balloon angioplasty, each additional visceral artery, radiological 30-Sep-08 2
procedure)
75970 Transcatheter biopsy, radiological supervision and interpretation 30-Sep-08 2
75978 Transluminal balloon angioplasty, venous (eg, subclavian stenosis), radiological 30-Sep-08
75980 Percutaneous transhepatic biliary drainage with contrast monitoring, radiological 30-Sep-08 1
75982 Percutaneous placement of drainage catheter for combined internal and external 30-Sep-08 2
biliary drainage or of a drainage stent for internal biliary drainage in patients
with an inoperable mechanical biliary obstruction, radiological supervision and
interpretation
75984 Change of percutaneous tube or drainage catheter with contrast monitoring (eg, 30-Sep-08 2
genitourinary system, abscess), radiological supervision and interpretation
75989 Radiological guidance (ie, fluoroscopy, ultrasound, or computed tomography), for 30-Sep-08 2
percutaneous drainage (eg, abscess, specimen collection), with placement of
catheter, radiological supervision and interpretation
75992 Transluminal atherectomy, peripheral artery, radiological supervision and 30-Sep-08 14-Oct-12
interpretation
75993 Transluminal atherectomy, each additional peripheral artery, radiological 30-Sep-08 14-Oct-12
procedure)
75994 Transluminal atherectomy, renal, radiological supervision and interpretation 30-Sep-08 14-Oct-12
75995 Transluminal atherectomy, visceral, radiological supervision and interpretation 30-Sep-08 14-Oct-12
75996 Transluminal atherectomy, each additional visceral artery, radiological 30-Sep-08 14-Oct-12
procedure)
76000 Fluoroscopy (separate procedure), up to 1 hour physician time, other than 71023 30-Sep-08 3
or 71034 (eg, cardiac fluoroscopy)
76001 Fluoroscopy, physician time more than 1 hour, assisting a nonradiologic 30-Sep-08 2
physician (eg, nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy)
76010 Radiologic examination from nose to rectum for foreign body, single view, child 30-Sep-08 2
76080 Radiologic examination, abscess, fistula or sinus tract study, radiological 30-Sep-08 2
76098 Radiological examination, surgical specimen 30-Sep-08
76100 Radiologic examination, single plane body section (eg, tomography), other than 30-Sep-08 2
with urography
76101 Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, 30-Sep-08 1
mastoid polytomography), other than with urography; unilateral
76102 Radiologic examination, complex motion (ie, hypercycloidal) body section (eg, 30-Sep-08 1
mastoid polytomography), other than with urography; bilateral
76120 Cineradiography/videoradiography, except where specifically included 30-Sep-08 1
76125 Cineradiography/videoradiography to complement routine examination (List 30-Sep-08 1

76140 Consultation on X-ray examination made elsewhere, written report 30-Sep-08

76150 Xeroradiography 30-Sep-08 14-Oct-12
76350 Subtraction in conjunction with contrast studies 30-Sep-08 14-Oct-12
76376 3D rendering with interpretation and reporting of computed tomography, 30-Sep-08 2
magnetic resonance imaging, ultrasound, or other tomographic modality; not
requiring image postprocessing on an independent workstation
76377 3D rendering with interpretation and reporting of computed tomography, 30-Sep-08 2

magnetic resonance imaging, ultrasound, or other tomographic modality;
requiring image postprocessing on an independent workstation
76380 Computed tomography, limited or localized follow-up study 30-Sep-08 1

76390 Magnetic resonance spectroscopy 30-Sep-08
76496 Unlisted fluoroscopic procedure (eg, diagnostic, interventional) 30-Sep-08
76497 Unlisted computed tomography procedure (eg, diagnostic, interventional) 30-Sep-08
76498 Unlisted magnetic resonance procedure (eg, diagnostic, interventional) 30-Sep-08
76499 Unlisted diagnostic radiographic procedure 30-Sep-08

76506 Echoencephalography, real time with image documentation (gray scale) (for 30-Sep-08 1
determination of ventricular size, delineation of cerebral contents, and detection
of fluid masses or other intracranial abnormalities), including A-mode
encephalography as secondary component where indicated
76510 Ophthalmic ultrasound, diagnostic; B-scan and quantitative A-scan performed 30-Sep-08 2
during the same patient encounter
76511 Ophthalmic ultrasound, diagnostic; quantitative A-scan only 30-Sep-08 2
76512 Ophthalmic ultrasound, diagnostic; B-scan (with or without superimposed non- 30-Sep-08 2
quantitative A-scan)
76513 Ophthalmic ultrasound, diagnostic; anterior segment ultrasound, immersion 30-Sep-08 2
(water bath) B-scan or high resolution biomicroscopy
76514 Ophthalmic ultrasound, diagnostic; corneal pachymetry, unilateral or bilateral 30-Sep-08 1
(determination of corneal thickness)
76516 Ophthalmic biometry by ultrasound echography, A-scan; 30-Sep-08 1
76519 Ophthalmic biometry by ultrasound echography, A-scan; with intraocular lens 30-Sep-08 2
power calculation
76529 Ophthalmic ultrasonic foreign body localization 30-Sep-08 2
76536 Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real 30-Sep-08 1
time with image documentation
76604 Ultrasound, chest (includes mediastinum), real time with image documentation 30-Sep-08 1
76645 Ultrasound, breast(s) (unilateral or bilateral), real time with image 30-Sep-08 1
documentation
76700 Ultrasound, abdominal, real time with image documentation; complete 30-Sep-08 1
76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single 30-Sep-08 2
organ, quadrant, follow-up)
76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image 30-Sep-08 1
documentation; complete
76775 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image 30-Sep-08 2
documentation; limited
76776 Ultrasound, transplanted kidney, real time and duplex Doppler with image 30-Sep-08 1
documentation
76800 Ultrasound, spinal canal and contents 30-Sep-08 1
76801 Ultrasound, pregnant uterus, real time with image documentation, fetal and 30-Sep-08 1
maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal
approach; single or first gestation
maternal evaluation, first trimester (< 14 weeks 0 days), transabdominal
approach; each additional gestation (List separately in addition to code for
primary procedure)
maternal evaluation, after first trimester (> or = 14 weeks 0 days),
transabdominal approach; single or first gestation
maternal evaluation, after first trimester (> or = 14 weeks 0 days),
transabdominal approach; each additional gestation (List separately in addition
maternal evaluation plus detailed fetal anatomic examination, transabdominal
maternal evaluation plus detailed fetal anatomic examination, transabdominal
primary procedure)
76813 Ultrasound, pregnant uterus, real time with image documentation, first trimester 30-Sep-08 1
fetal nuchal translucency measurement, transabdominal or transvaginal
76814 Ultrasound, pregnant uterus, real time with image documentation, first trimester 30-Sep-08 3
fetal nuchal translucency measurement, transabdominal or transvaginal
primary procedure)
76815 Ultrasound, pregnant uterus, real time with image documentation, limited (eg, 30-Sep-08 1
fetal heart beat, placental location, fetal position and/or qualitative amniotic
fluid volume), 1 or more fetuses
76816 Ultrasound, pregnant uterus, real time with image documentation, follow-up (eg, 30-Sep-08
re-evaluation of fetal size by measuring standard growth parameters and
amniotic fluid volume, re-evaluation of organ system(s) suspected or confirmed
to be abnormal on a previous scan), transabdominal approach, per fetus
76817 Ultrasound, pregnant uterus, real time with image documentation, transvaginal 30-Sep-08 1
76818 Fetal biophysical profile; with non-stress testing 30-Sep-08

76819 Fetal biophysical profile; without non-stress testing 30-Sep-08
76820 Doppler velocimetry, fetal; umbilical artery 30-Sep-08
76821 Doppler velocimetry, fetal; middle cerebral artery 30-Sep-08
76825 Echocardiography, fetal, cardiovascular system, real time with image 30-Sep-08
documentation (2D), with or without M-mode recording;
76826 Echocardiography, fetal, cardiovascular system, real time with image 30-Sep-08
documentation (2D), with or without M-mode recording; follow-up or repeat
study
76827 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with 30-Sep-08
spectral display; complete
76828 Doppler echocardiography, fetal, pulsed wave and/or continuous wave with 30-Sep-08
spectral display; follow-up or repeat study
76830 Ultrasound, transvaginal 30-Sep-08 1
76831 Saline infusion sonohysterography (SIS), including color flow Doppler, when 30-Sep-08 1
performed
76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 30-Sep-08 1
76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or 30-Sep-08 1
follow-up (eg, for follicles)
76870 Ultrasound, scrotum and contents 30-Sep-08 1
76872 Ultrasound, transrectal; 30-Sep-08 1
76873 Ultrasound, transrectal; prostate volume study for brachytherapy treatment 30-Sep-08 1
planning (separate procedure)
76880 Ultrasound, extremity, nonvascular, real time with image documentation 30-Sep-08 14-Oct-12
76881 Ultrasound, extremity, nonvascular, real-time with image documentation; 15-Oct-12 2

complete
76882 Ultrasound, extremity, nonvascular, real-time with image documentation; 15-Oct-12 2
limited, anatomic specific
76885 Ultrasound, infant hips, real time with imaging documentation; dynamic 30-Sep-08 1
(requiring physician manipulation)
76886 Ultrasound, infant hips, real time with imaging documentation; limited, static 30-Sep-08 1
(not requiring physician manipulation)
76930 Ultrasonic guidance for pericardiocentesis, imaging supervision and 30-Sep-08 1
interpretation
76932 Ultrasonic guidance for endomyocardial biopsy, imaging supervision and 30-Sep-08 1
interpretation
76936 Ultrasound guided compression repair of arterial pseudoaneurysm or 30-Sep-08 2
arteriovenous fistulae (includes diagnostic ultrasound evaluation, compression of
lesion and imaging)
76937 Ultrasound guidance for vascular access requiring ultrasound evaluation of 30-Sep-08 2
potential access sites, documentation of selected vessel patency, concurrent
realtime ultrasound visualization of vascular needle entry, with permanent
recording and reporting (List separately in addition to code for primary
procedure)
76940 Ultrasound guidance for, and monitoring of, parenchymal tissue ablation 30-Sep-08 1
76941 Ultrasonic guidance for intrauterine fetal transfusion or cordocentesis, imaging 30-Sep-08
76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, 30-Sep-08 1
localization device), imaging supervision and interpretation
76945 Ultrasonic guidance for chorionic villus sampling, imaging supervision and 30-Sep-08 1
interpretation
76946 Ultrasonic guidance for amniocentesis, imaging supervision and interpretation 30-Sep-08 1
76948 Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation 30-Sep-08 1
76950 Ultrasonic guidance for placement of radiation therapy fields 30-Sep-08 2

76965 Ultrasonic guidance for interstitial radioelement application 30-Sep-08 2
76970 Ultrasound study follow-up (specify) 30-Sep-08 1
76975 Gastrointestinal endoscopic ultrasound, supervision and interpretation 30-Sep-08 1
76977 Ultrasound bone density measurement and interpretation, peripheral site(s), any 30-Sep-08 1
method
76998 Ultrasonic guidance, intraoperative 30-Sep-08 1
76999 Unlisted ultrasound procedure (eg, diagnostic, interventional) 30-Sep-08
77001 Fluoroscopic guidance for central venous access device placement, replacement 30-Sep-08 1
(catheter only or complete), or removal (includes fluoroscopic guidance for
vascular access and catheter manipulation, any necessary contrast injections
through access site or catheter with related venography radiologic supervision
and interpretation, and radiographic documentation of final catheter position)
77002 Fluoroscopic guidance for needle placement (eg, biopsy, aspiration, injection, 30-Sep-08 1
localization device)
77003 Fluoroscopic guidance and localization of needle or catheter tip for spine or 30-Sep-08 1
paraspinous diagnostic or therapeutic injection procedures (epidural,
subarachnoid, or sacroiliac joint), including neurolytic agent destruction
77011 Computed tomography guidance for stereotactic localization 30-Sep-08 1

77012 Computed tomography guidance for needle placement (eg, biopsy, aspiration, 30-Sep-08 1
injection, localization device), radiological supervision and interpretation
77013 Computed tomography guidance for, and monitoring of, parenchymal tissue 30-Sep-08 1
ablation
77014 Computed tomography guidance for placement of radiation therapy fields 30-Sep-08 2
77021 Magnetic resonance guidance for needle placement (eg, for biopsy, needle 30-Sep-08 1
aspiration, injection, or placement of localization device) radiological supervision
and interpretation
77022 Magnetic resonance guidance for, and monitoring of, parenchymal tissue 30-Sep-08 1
ablation
77031 Stereotactic localization guidance for breast biopsy or needle placement (eg, for 30-Sep-08
wire localization or for injection), each lesion, radiological supervision and
interpretation
77032 Mammographic guidance for needle placement, breast (eg, for wire localization 30-Sep-08
or for injection), each lesion, radiological supervision and interpretation
77051 Computer-aided detection (computer algorithm analysis of digital image data for 30-Sep-08
lesion detection) with further physician review for interpretation, with or without
digitization of film radiographic images; diagnostic mammography (List
77052 Computer-aided detection (computer algorithm analysis of digital image data for 30-Sep-08
lesion detection) with further physician review for interpretation, with or without
digitization of film radiographic images; screening mammography (List
77053 Mammary ductogram or galactogram, single duct, radiological supervision and 30-Sep-08 2
interpretation
77054 Mammary ductogram or galactogram, multiple ducts, radiological supervision 30-Sep-08 2
and interpretation
77055 Mammography; unilateral 30-Sep-08
77056 Mammography; bilateral 30-Sep-08
77057 Screening mammography, bilateral (2-view film study of each breast) 30-Sep-08
77058 Magnetic resonance imaging, breast, without and/or with contrast material(s); 30-Sep-08 1
unilateral
77059 Magnetic resonance imaging, breast, without and/or with contrast material(s); 30-Sep-08 1
bilateral
77071 Manual application of stress performed by physician for joint radiography, 30-Sep-08 1
including contralateral joint if indicated
77072 Bone age studies 30-Sep-08
77073 Bone length studies (orthoroentgenogram, scanogram) 30-Sep-08
77074 Radiologic examination, osseous survey; limited (eg, for metastases) 30-Sep-08
77075 Radiologic examination, osseous survey; complete (axial and appendicular 30-Sep-08
skeleton)
77076 Radiologic examination, osseous survey, infant 30-Sep-08
77077 Joint survey, single view, 2 or more joints (specify) 30-Sep-08
77078 Computed tomography, bone mineral density study, 1 or more sites; axial 30-Sep-08
skeleton (eg, hips, pelvis, spine)
77079 Computed tomography, bone mineral density study, 1 or more sites; 30-Sep-08
appendicular skeleton (peripheral) (eg, radius, wrist, heel)
77080 Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; 30-Sep-08
axial skeleton (eg, hips, pelvis, spine)
appendicular skeleton (peripheral) (eg, radius, wrist, heel)
vertebral fracture assessment
77083 Radiographic absorptiometry (eg, photodensitometry, radiogrammetry), 1 or 30-Sep-08
more sites
77084 Magnetic resonance (eg, proton) imaging, bone marrow blood supply 30-Sep-08
77261 Therapeutic radiology treatment planning; simple 30-Sep-08 1
77262 Therapeutic radiology treatment planning; intermediate 30-Sep-08 1
77263 Therapeutic radiology treatment planning; complex 30-Sep-08 1
77280 Therapeutic radiology simulation-aided field setting; simple 30-Sep-08 2
77285 Therapeutic radiology simulation-aided field setting; intermediate 30-Sep-08 1
77290 Therapeutic radiology simulation-aided field setting; complex 30-Sep-08 1
77295 Therapeutic radiology simulation-aided field setting; 3-dimensional 30-Sep-08 1
77299 Unlisted procedure, therapeutic radiology clinical treatment planning 30-Sep-08
77300 Basic radiation dosimetry calculation, central axis depth dose calculation, TDF, 30-Sep-08
NSD, gap calculation, off axis factor, tissue inhomogeneity factors, calculation of
non-ionizing radiation surface and depth dose, as required during course of
treatment, only when prescribed by the treating physician
77301 Intensity modulated radiotherapy plan, including dose-volume histograms for 30-Sep-08 1
target and critical structure partial tolerance specifications
77305 Teletherapy, isodose plan (whether hand or computer calculated); simple (1 or 2 30-Sep-08 2
parallel opposed unmodified ports directed to a single area of interest)
77310 Teletherapy, isodose plan (whether hand or computer calculated); intermediate 30-Sep-08 2
(3 or more treatment ports directed to a single area of interest)
77315 Teletherapy, isodose plan (whether hand or computer calculated); complex 30-Sep-08 2
(mantle or inverted Y, tangential ports, the use of wedges, compensators,
complex blocking, rotational beam, or special beam considerations)
77321 Special teletherapy port plan, particles, hemibody, total body 30-Sep-08 1
77326 Brachytherapy isodose plan; simple (calculation made from single plane, 1 to 4 30-Sep-08 1
sources/ribbon application, remote afterloading brachytherapy, 1 to 8 sources)
77327 Brachytherapy isodose plan; intermediate (multiplane dosage calculations, 30-Sep-08 1

application involving 5 to 10 sources/ribbons, remote afterloading
brachytherapy, 9 to 12 sources)
77328 Brachytherapy isodose plan; complex (multiplane isodose plan, volume implant 30-Sep-08 1
calculations, over 10 sources/ribbons used, special spatial reconstruction,
remote afterloading brachytherapy, over 12 sources)
77331 Special dosimetry (eg, TLD, microdosimetry) (specify), only when prescribed by 30-Sep-08
the treating physician
77332 Treatment devices, design and construction; simple (simple block, simple bolus) 30-Sep-08 4
77333 Treatment devices, design and construction; intermediate (multiple blocks, 30-Sep-08 4
stents, bite blocks, special bolus)
77334 Treatment devices, design and construction; complex (irregular blocks, special 30-Sep-08
shields, compensators, wedges, molds or casts)
77336 Continuing medical physics consultation, including assessment of treatment 30-Sep-08 1
parameters, quality assurance of dose delivery, and review of patient treatment
documentation in support of the radiation oncologist, reported per week of
therapy
77338 Multi-leaf collimator (MLC) device(s) for intensity modulated radiation therapy 15-Oct-12
(IMRT), design and construction per IMRT plan
77370 Special medical radiation physics consultation 30-Sep-08 1
77371 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course 30-Sep-08 1
of treatment of cranial lesion(s) consisting of 1 session; multi-source Cobalt 60
based
77372 Radiation treatment delivery, stereotactic radiosurgery (SRS), complete course 30-Sep-08 1
of treatment of cranial lesion(s) consisting of 1 session; linear accelerator based
77373 Stereotactic body radiation therapy, treatment delivery, per fraction to 1 or more 30-Sep-08 1
lesions, including image guidance, entire course not to exceed 5 fractions
77399 Unlisted procedure, medical radiation physics, dosimetry and treatment devices, 30-Sep-08
and special services
77401 Radiation treatment delivery, superficial and/or ortho voltage 30-Sep-08 2
77402 Radiation treatment delivery, single treatment area, single port or parallel 30-Sep-08 2
opposed ports, simple blocks or no blocks; up to 5 MeV
opposed ports, simple blocks or no blocks; 6-10 MeV
opposed ports, simple blocks or no blocks; 11-19 MeV
opposed ports, simple blocks or no blocks; 20 MeV or greater
77407 Radiation treatment delivery, 2 separate treatment areas, 3 or more ports on a 30-Sep-08 2
single treatment area, use of multiple blocks; up to 5 MeV
single treatment area, use of multiple blocks; 6-10 MeV
single treatment area, use of multiple blocks; 11-19 MeV
single treatment area, use of multiple blocks; 20 MeV or greater
77412 Radiation treatment delivery, 3 or more separate treatment areas, custom 30-Sep-08 2
blocking, tangential ports, wedges, rotational beam, compensators, electron
beam; up to 5 MeV
beam; 6-10 MeV
beam; 11-19 MeV
beam; 20 MeV or greater
77417 Therapeutic radiology port film(s) 30-Sep-08 1
77418 Intensity modulated treatment delivery, single or multiple fields/arcs, via narrow 30-Sep-08 2
spatially and temporally modulated beams, binary, dynamic MLC, per treatment
session
77421 Stereoscopic X-ray guidance for localization of target volume for the delivery of 30-Sep-08 2
radiation therapy
77422 High energy neutron radiation treatment delivery; single treatment area using a 30-Sep-08 1
single port or parallel-opposed ports with no blocks or simple blocking
77423 High energy neutron radiation treatment delivery; 1 or more isocenter(s) with 30-Sep-08 1
coplanar or non-coplanar geometry with blocking and/or wedge, and/or
compensator(s)
77427 Radiation treatment management, 5 treatments 30-Sep-08 1
77431 Radiation therapy management with complete course of therapy consisting of 1 30-Sep-08 1
or 2 fractions only
77432 Stereotactic radiation treatment management of cranial lesion(s) (complete 30-Sep-08 1
course of treatment consisting of 1 session)
77435 Stereotactic body radiation therapy, treatment management, per treatment 30-Sep-08 1
course, to 1 or more lesions, including image guidance, entire course not to
exceed 5 fractions
77470 Special treatment procedure (eg, total body irradiation, hemibody radiation, per 30-Sep-08 1
oral, endocavitary or intraoperative cone irradiation)
77499 Unlisted procedure, therapeutic radiology treatment management 30-Sep-08
77520 Proton treatment delivery; simple, without compensation 30-Sep-08 1

77522 Proton treatment delivery; simple, with compensation 30-Sep-08 1
77523 Proton treatment delivery; intermediate 30-Sep-08 1
77525 Proton treatment delivery; complex 30-Sep-08 1
77600 Hyperthermia, externally generated; superficial (ie, heating to a depth of 4 cm or 30-Sep-08 1
less)
77605 Hyperthermia, externally generated; deep (ie, heating to depths greater than 4 30-Sep-08 1
cm)
77610 Hyperthermia generated by interstitial probe(s); 5 or fewer interstitial applicators 30-Sep-08 1
77615 Hyperthermia generated by interstitial probe(s); more than 5 interstitial 30-Sep-08 1

applicators
77620 Hyperthermia generated by intracavitary probe(s) 30-Sep-08 1
77750 Infusion or instillation of radioelement solution (includes 3-month follow-up care) 30-Sep-08 1
77761 Intracavitary radiation source application; simple 30-Sep-08 1

77762 Intracavitary radiation source application; intermediate 30-Sep-08 1
77763 Intracavitary radiation source application; complex 30-Sep-08 1
77776 Interstitial radiation source application; simple 30-Sep-08 1
77777 Interstitial radiation source application; intermediate 30-Sep-08 1
77778 Interstitial radiation source application; complex 30-Sep-08 1
77781 Remote afterloading high intensity brachytherapy; 1-4 source positions or 30-Sep-08 14-Oct-12
catheters
catheters
catheters
77784 Remote afterloading high intensity brachytherapy; over 12 source positions or 30-Sep-08 14-Oct-12
catheters
77785 Remote afterloading high dose rate radionuclide brachytherapy; 1 channel 15-Oct-12 3
77786 Remote afterloading high dose rate radionuclide brachytherapy; 2-12 channels 15-Oct-12 3
77787 Remote afterloading high dose rate radionuclide brachytherapy; over 12 15-Oct-12 3
channels
77789 Surface application of radiation source 30-Sep-08 2
77790 Supervision, handling, loading of radiation source 30-Sep-08 2
77799 Unlisted procedure, clinical brachytherapy 30-Sep-08
78000 Thyroid uptake; single determination 30-Sep-08 1

78001 Thyroid uptake; multiple determinations 30-Sep-08 1
78003 Thyroid uptake; stimulation, suppression or discharge (not including initial 30-Sep-08 1
uptake studies)
78006 Thyroid imaging, with uptake; single determination 30-Sep-08 1
78007 Thyroid imaging, with uptake; multiple determinations 30-Sep-08 1
78010 Thyroid imaging; only 30-Sep-08 1
78011 Thyroid imaging; with vascular flow 30-Sep-08 1
78015 Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) 30-Sep-08 1
78016 Thyroid carcinoma metastases imaging; with additional studies (eg, urinary 30-Sep-08 1
recovery)
78018 Thyroid carcinoma metastases imaging; whole body 30-Sep-08 1
78020 Thyroid carcinoma metastases uptake (List separately in addition to code for 30-Sep-08 1
primary procedure)
78070 Parathyroid imaging 30-Sep-08 1
78075 Adrenal imaging, cortex and/or medulla 30-Sep-08 1
78099 Unlisted endocrine procedure, diagnostic nuclear medicine 30-Sep-08
78102 Bone marrow imaging; limited area 30-Sep-08 1

78103 Bone marrow imaging; multiple areas 30-Sep-08 1
78104 Bone marrow imaging; whole body 30-Sep-08 1
78110 Plasma volume, radiopharmaceutical volume-dilution technique (separate 30-Sep-08 1
procedure); single sampling
78111 Plasma volume, radiopharmaceutical volume-dilution technique (separate 30-Sep-08 1
procedure); multiple samplings
78120 Red cell volume determination (separate procedure); single sampling 30-Sep-08 1
78121 Red cell volume determination (separate procedure); multiple samplings 30-Sep-08 1
78122 Whole blood volume determination, including separate measurement of plasma 30-Sep-08 1
volume and red cell volume (radiopharmaceutical volume-dilution technique)
78130 Red cell survival study; 30-Sep-08 1
78135 Red cell survival study; differential organ/tissue kinetics (eg, splenic and/or 30-Sep-08 1
hepatic sequestration)
78140 Labeled red cell sequestration, differential organ/tissue (eg, splenic and/or 30-Sep-08 1
hepatic)
78185 Spleen imaging only, with or without vascular flow 30-Sep-08 1
78190 Kinetics, study of platelet survival, with or without differential organ/tissue 30-Sep-08 1
localization
78191 Platelet survival study 30-Sep-08 1
78195 Lymphatics and lymph nodes imaging 30-Sep-08 1
78199 Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic 30-Sep-08
nuclear medicine
78201 Liver imaging; static only 30-Sep-08 1
78202 Liver imaging; with vascular flow 30-Sep-08 1
78205 Liver imaging (SPECT); 30-Sep-08 1
78206 Liver imaging (SPECT); with vascular flow 30-Sep-08 1
78215 Liver and spleen imaging; static only 30-Sep-08 1
78216 Liver and spleen imaging; with vascular flow 30-Sep-08 1
78220 Liver function study with hepatobiliary agents, with serial images 30-Sep-08 1
78223 Hepatobiliary ductal system imaging, including gallbladder, with or without 30-Sep-08 1
pharmacologic intervention, with or without quantitative measurement of
gallbladder function
78230 Salivary gland imaging; 30-Sep-08 1
78231 Salivary gland imaging; with serial images 30-Sep-08 1
78232 Salivary gland function study 30-Sep-08 1
78258 Esophageal motility 30-Sep-08 1
78261 Gastric mucosa imaging 30-Sep-08 1
78262 Gastroesophageal reflux study 30-Sep-08 1
78264 Gastric emptying study 30-Sep-08 1
78267 Urea breath test, C-14 (isotopic); acquisition for analysis 30-Sep-08 1
78268 Urea breath test, C-14 (isotopic); analysis 30-Sep-08 1
78270 Vitamin B-12 absorption study (eg, Schilling test); without intrinsic factor 30-Sep-08 1
78271 Vitamin B-12 absorption study (eg, Schilling test); with intrinsic factor 30-Sep-08 1
78272 Vitamin B-12 absorption studies combined, with and without intrinsic factor 30-Sep-08 1
78278 Acute gastrointestinal blood loss imaging 30-Sep-08 2

78282 Gastrointestinal protein loss 30-Sep-08 1
78290 Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) 30-Sep-08 1
78291 Peritoneal-venous shunt patency test (eg, for LeVeen, Denver shunt) 30-Sep-08 1
78299 Unlisted gastrointestinal procedure, diagnostic nuclear medicine 30-Sep-08
78300 Bone and/or joint imaging; limited area 30-Sep-08 1

78305 Bone and/or joint imaging; multiple areas 30-Sep-08 1
78306 Bone and/or joint imaging; whole body 30-Sep-08 1
78315 Bone and/or joint imaging; 3 phase study 30-Sep-08 1
78320 Bone and/or joint imaging; tomographic (SPECT) 30-Sep-08 1
78350 Bone density (bone mineral content) study, 1 or more sites; single photon 30-Sep-08
absorptiometry
78351 Bone density (bone mineral content) study, 1 or more sites; dual photon 30-Sep-08
absorptiometry, 1 or more sites
78399 Unlisted musculoskeletal procedure, diagnostic nuclear medicine 30-Sep-08
78414 Determination of central c-v hemodynamics (non-imaging) (eg, ejection fraction 30-Sep-08 1
with probe technique) with or without pharmacologic intervention or exercise,
single or multiple determinations
78428 Cardiac shunt detection 30-Sep-08 1

78445 Non-cardiac vascular flow imaging (ie, angiography, venography) 30-Sep-08 1
78451 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation 15-Oct-12
correction, qualitative or quantitative wall motion, ejection fraction by first pass
or gated technique, additional quantification, when performed); single study, at
rest or stress (exercise or pharmacologic)
78452 Myocardial perfusion imaging, tomographic (SPECT) (including attenuation 15-Oct-12
correction, qualitative or quantitative wall motion, ejection fraction by first pass
or gated technique, additional quantification, when performed); multiple studies,
at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest
reinjection
78453 Myocardial perfusion imaging, planar (including qualitative or quantitative wall 15-Oct-12
motion, ejection fraction by first pass or gated technique, additional
quantification, when performed); single study, at rest or stress (exercise or
pharmacologic)
78454 Myocardial perfusion imaging, planar (including qualitative or quantitative wall 15-Oct-12
motion, ejection fraction by first pass or gated technique, additional
quantification, when performed); multiple studies, at rest and/or stress (exercise
or pharmacologic) and/or redistribution and/or rest reinjection
78456 Acute venous thrombosis imaging, peptide 30-Sep-08 1

78457 Venous thrombosis imaging, venogram; unilateral 30-Sep-08 1
78458 Venous thrombosis imaging, venogram; bilateral 30-Sep-08 1
78459 Myocardial imaging, positron emission tomography (PET), metabolic evaluation 30-Sep-08 1
78460 Myocardial perfusion imaging; (planar) single study, at rest or stress (exercise 30-Sep-08 14-Oct-12
and/or pharmacologic), with or without quantification
78461 Myocardial perfusion imaging; multiple studies (planar), at rest and/or stress 30-Sep-08 14-Oct-12
(exercise and/or pharmacologic), and redistribution and/or rest injection, with or
without quantification
78464 Myocardial perfusion imaging; tomographic (SPECT), single study (including 30-Sep-08 14-Oct-12
attenuation correction when performed), at rest or stress (exercise and/or
pharmacologic), with or without quantification
78465 Myocardial perfusion imaging; tomographic (SPECT), multiple studies (including 30-Sep-08 14-Oct-12
attenuation correction when performed), at rest and/or stress (exercise and/or
pharmacologic) and redistribution and/or rest injection, with or without
quantification
78466 Myocardial imaging, infarct avid, planar; qualitative or quantitative 30-Sep-08 1
78468 Myocardial imaging, infarct avid, planar; with ejection fraction by first pass 30-Sep-08 1
technique
78469 Myocardial imaging, infarct avid, planar; tomographic SPECT with or without 30-Sep-08 1
quantification
78472 Cardiac blood pool imaging, gated equilibrium; planar, single study at rest or 30-Sep-08 1
stress (exercise and/or pharmacologic), wall motion study plus ejection fraction,
with or without additional quantitative processing
78473 Cardiac blood pool imaging, gated equilibrium; multiple studies, wall motion 30-Sep-08 1
study plus ejection fraction, at rest and stress (exercise and/or pharmacologic),
with or without additional quantification
78478 Myocardial perfusion study with wall motion, qualitative or quantitative study 30-Sep-08 14-Oct-12
78480 Myocardial perfusion study with ejection fraction (List separately in addition to 30-Sep-08 14-Oct-12
78481 Cardiac blood pool imaging (planar), first pass technique; single study, at rest or 30-Sep-08 1
with stress (exercise and/or pharmacologic), wall motion study plus ejection
fraction, with or without quantification
78483 Cardiac blood pool imaging (planar), first pass technique; multiple studies, at 30-Sep-08 1
rest and with stress (exercise and/or pharmacologic), wall motion study plus
ejection fraction, with or without quantification
78491 Myocardial imaging, positron emission tomography (PET), perfusion; single study 30-Sep-08 1
at rest or stress
78492 Myocardial imaging, positron emission tomography (PET), perfusion; multiple 30-Sep-08 1
studies at rest and/or stress
78494 Cardiac blood pool imaging, gated equilibrium, SPECT, at rest, wall motion study 30-Sep-08 1
plus ejection fraction, with or without quantitative processing
78496 Cardiac blood pool imaging, gated equilibrium, single study, at rest, with right 30-Sep-08 1
ventricular ejection fraction by first pass technique (List separately in addition to
78499 Unlisted cardiovascular procedure, diagnostic nuclear medicine 30-Sep-08
78580 Pulmonary perfusion imaging, particulate 30-Sep-08 1

78584 Pulmonary perfusion imaging, particulate, with ventilation; single breath 30-Sep-08 2
78585 Pulmonary perfusion imaging, particulate, with ventilation; rebreathing and 30-Sep-08 2
washout, with or without single breath
78586 Pulmonary ventilation imaging, aerosol; single projection 30-Sep-08 1
78587 Pulmonary ventilation imaging, aerosol; multiple projections (eg, anterior, 30-Sep-08 1
posterior, lateral views)
78588 Pulmonary perfusion imaging, particulate, with ventilation imaging, aerosol, 1 or 30-Sep-08 1
multiple projections
78591 Pulmonary ventilation imaging, gaseous, single breath, single projection 30-Sep-08 1
78593 Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or 30-Sep-08 1
without single breath; single projection
78594 Pulmonary ventilation imaging, gaseous, with rebreathing and washout with or 30-Sep-08 1
without single breath; multiple projections (eg, anterior, posterior, lateral views)
78596 Pulmonary quantitative differential function (ventilation/perfusion) study 30-Sep-08 1
78599 Unlisted respiratory procedure, diagnostic nuclear medicine 30-Sep-08
78600 Brain imaging, less than 4 static views; 30-Sep-08 1

78601 Brain imaging, less than 4 static views; with vascular flow 30-Sep-08 1
78605 Brain imaging, minimum 4 static views; 30-Sep-08 1
78606 Brain imaging, minimum 4 static views; with vascular flow 30-Sep-08 2
78607 Brain imaging, tomographic (SPECT) 30-Sep-08 1
78608 Brain imaging, positron emission tomography (PET); metabolic evaluation 30-Sep-08 1
78609 Brain imaging, positron emission tomography (PET); perfusion evaluation 30-Sep-08
78610 Brain imaging, vascular flow only 30-Sep-08 1

78630 Cerebrospinal fluid flow, imaging (not including introduction of material); 30-Sep-08 2
cisternography
ventriculography
78645 Cerebrospinal fluid flow, imaging (not including introduction of material); shunt 30-Sep-08 1
evaluation
tomographic (SPECT)
78650 Cerebrospinal fluid leakage detection and localization 30-Sep-08 1
78660 Radiopharmaceutical dacryocystography 30-Sep-08 1
78699 Unlisted nervous system procedure, diagnostic nuclear medicine 30-Sep-08
78700 Kidney imaging morphology; 30-Sep-08 1

78701 Kidney imaging morphology; with vascular flow 30-Sep-08 2
78707 Kidney imaging morphology; with vascular flow and function, single study 30-Sep-08 1
without pharmacological intervention
78708 Kidney imaging morphology; with vascular flow and function, single study, with 30-Sep-08 1
pharmacological intervention (eg, angiotensin converting enzyme inhibitor
and/or diuretic)
78709 Kidney imaging morphology; with vascular flow and function, multiple studies, 30-Sep-08 1
with and without pharmacological intervention (eg, angiotensin converting
enzyme inhibitor and/or diuretic)
78710 Kidney imaging morphology; tomographic (SPECT) 30-Sep-08 1
78725 Kidney function study, non-imaging radioisotopic study 30-Sep-08 1
78730 Urinary bladder residual study (List separately in addition to code for primary 30-Sep-08 1
procedure)
78740 Ureteral reflux study (radiopharmaceutical voiding cystogram) 30-Sep-08 1
78761 Testicular imaging with vascular flow 30-Sep-08 1
78799 Unlisted genitourinary procedure, diagnostic nuclear medicine 30-Sep-08
78800 Radiopharmaceutical localization of tumor or distribution of radiopharmaceutical 30-Sep-08 1

agent(s); limited area
agent(s); multiple areas
agent(s); whole body, single day imaging
agent(s); tomographic (SPECT)
agent(s); whole body, requiring 2 or more days imaging
78805 Radiopharmaceutical localization of inflammatory process; limited area 30-Sep-08 1
78806 Radiopharmaceutical localization of inflammatory process; whole body 30-Sep-08 1
78807 Radiopharmaceutical localization of inflammatory process; tomographic (SPECT) 30-Sep-08 1
78808 Injection procedure for radiopharmaceutical localization by non-imaging probe 15-Oct-12 1

study, intravenous (eg, parathyroid adenoma)
78811 Positron emission tomography (PET) imaging; limited area (eg, chest, head/neck) 30-Sep-08 1
78812 Positron emission tomography (PET) imaging; skull base to mid-thigh 30-Sep-08 1
78813 Positron emission tomography (PET) imaging; whole body 30-Sep-08 1
78814 Positron emission tomography (PET) with concurrently acquired computed 30-Sep-08 1
tomography (CT) for attenuation correction and anatomical localization imaging;
limited area (eg, chest, head/neck)
skull base to mid-thigh
whole body
78890 Generation of automated data: interactive process involving nuclear physician 30-Sep-08 14-Oct-12
and/or allied health professional personnel; simple manipulations and
interpretation, not to exceed 30 minutes
78891 Generation of automated data: interactive process involving nuclear physician 30-Sep-08 14-Oct-12
and/or allied health professional personnel; complex manipulations and
interpretation, exceeding 30 minutes
78999 Unlisted miscellaneous procedure, diagnostic nuclear medicine 30-Sep-08
79005 Radiopharmaceutical therapy, by oral administration 30-Sep-08 1

79101 Radiopharmaceutical therapy, by intravenous administration 30-Sep-08 1
79200 Radiopharmaceutical therapy, by intracavitary administration 30-Sep-08 1
79300 Radiopharmaceutical therapy, by interstitial radioactive colloid administration 30-Sep-08 1
79403 Radiopharmaceutical therapy, radiolabeled monoclonal antibody by intravenous 30-Sep-08 1

infusion
79440 Radiopharmaceutical therapy, by intra-articular administration 30-Sep-08 1
79445 Radiopharmaceutical therapy, by intra-arterial particulate administration 30-Sep-08 1
79999 Radiopharmaceutical therapy, unlisted procedure 30-Sep-08
80047 Basic metabolic panel (Calcium, ionized) This panel must include the following: 30-Sep-08 2
Calcium, ionized (82330), Carbon dioxide (82374), Chloride (82435), Creatinine
(82565), Glucose (82947), Potassium (84132), Sodium (84295), Urea Nitrogen
(BUN) (84520)
80048 Basic metabolic panel (Calcium, total) This panel must include the following: 30-Sep-08 2
Calcium, total (82310), Carbon dioxide (82374), Chloride (82435), Creatinine
(82565), Glucose (82947), Potassium (84132), Sodium (84295), Urea nitrogen
(BUN) (84520)
80050 General health panel This panel must include the following: Comprehensive 30-Sep-08
metabolic panel (80053), Blood count, complete (CBC), automated and
automated differential WBC count (85025 or 85027 and 85004), OR, Blood
count, complete (CBC), automated (85027) and appropriate manual differential
WBC count (85007 or 85009), Thyroid stimulating hormone (TSH) (84443)
80051 Electrolyte panel This panel must include the following: Carbon dioxide (82374), 30-Sep-08 2
Chloride (82435), Potassium (84132), Sodium (84295)
80053 Comprehensive metabolic panel This panel must include the following: Albumin 30-Sep-08 1
(82040), Bilirubin, total (82247), Calcium, total (82310), Carbon dioxide
(bicarbonate) (82374), Chloride (82435), Creatinine (82565), Glucose (82947),
Phosphatase, alkaline (84075), Potassium (84132), Protein, total (84155),
Sodium (84295), Transferase, alanine amino (ALT) (SGPT) (84460), Transferase,
aspartate amino (AST) (SGOT) (84450), Urea nitrogen (BUN) (84520)
80055 Obstetric panel This panel must include the following: Blood count, complete 30-Sep-08
(CBC), automated and automated differential WBC count (85025 or 85027 and
85004), OR, Blood count, complete (CBC), automated (85027) and appropriate
manual differential WBC count (85007 or 85009), Hepatitis B surface antigen
(HBsAg) (87340), Antibody, rubella (86762), Syphilis test, non-treponemal
antibody; qualitative (eg, VDRL, RPR, ART) (86592), Antibody screen, RBC, each
serum technique (86850), Blood typing, ABO (86900) AND, Blood typing, Rh (D)
(86901)
80061 Lipid panel This panel must include the following: Cholesterol, serum, total 30-Sep-08 1
(82465), Lipoprotein, direct measurement, high density cholesterol (HDL
cholesterol) (83718), Triglycerides (84478)
80069 Renal function panel This panel must include the following: Albumin (82040), 30-Sep-08 1
Calcium, total (82310), Carbon dioxide (bicarbonate) (82374), Chloride (82435),
Creatinine (82565), Glucose (82947), Phosphorus inorganic (phosphate) (84100),
Potassium (84132), Sodium (84295), Urea nitrogen (BUN) (84520)
80074 Acute hepatitis panel This panel must include the following: Hepatitis A antibody 30-Sep-08 1
(HAAb), IgM antibody (86709), Hepatitis B core antibody (HBcAb), IgM antibody
(86705), Hepatitis B surface antigen (HBsAg) (87340), Hepatitis C antibody
(86803)
80076 Hepatic function panel This panel must include the following: Albumin (82040), 30-Sep-08 1
Bilirubin, total (82247), Bilirubin, direct (82248), Phosphatase, alkaline (84075),
Protein, total (84155), Transferase, alanine amino (ALT) (SGPT) (84460),
Transferase, aspartate amino (AST) (SGOT) (84450)
80100 Drug screen, qualitative; multiple drug classes chromatographic method, each 30-Sep-08
procedure
80101 Drug screen, qualitative; single drug class method (eg, immunoassay, enzyme 30-Sep-08
assay), each drug class
80102 Drug confirmation, each procedure 30-Sep-08
80103 Tissue preparation for drug analysis 30-Sep-08 2
80104 Drug screen, qualitative; multiple drug classes other than chromatographic 15-Oct-12 1
method, each procedure
80150 Amikacin 30-Sep-08 2
80152 Amitriptyline 30-Sep-08 2
80154 Benzodiazepines 30-Sep-08 2
80156 Carbamazepine; total 30-Sep-08 2
80157 Carbamazepine; free 30-Sep-08 2
80158 Cyclosporine 30-Sep-08 2
80160 Desipramine 30-Sep-08 2
80162 Digoxin 30-Sep-08 2
80164 Dipropylacetic acid (valproic acid) 30-Sep-08 2
80166 Doxepin 30-Sep-08 2
80168 Ethosuximide 30-Sep-08 2
80170 Gentamicin 30-Sep-08 2
80172 Gold 30-Sep-08 2
80173 Haloperidol 30-Sep-08 2
80174 Imipramine 30-Sep-08 2
80176 Lidocaine 30-Sep-08 1
80178 Lithium 30-Sep-08 2
80182 Nortriptyline 30-Sep-08 2
80184 Phenobarbital 30-Sep-08 2
80185 Phenytoin; total 30-Sep-08 2
80186 Phenytoin; free 30-Sep-08 2
80188 Primidone 30-Sep-08 2
80190 Procainamide; 30-Sep-08 2
80192 Procainamide; with metabolites (eg, n-acetyl procainamide) 30-Sep-08 2
80194 Quinidine 30-Sep-08 2
80195 Sirolimus 30-Sep-08 2
80196 Salicylate 30-Sep-08
80197 Tacrolimus 30-Sep-08 2
80198 Theophylline 30-Sep-08 2
80200 Tobramycin 30-Sep-08 2
80201 Topiramate 30-Sep-08 2
80202 Vancomycin 30-Sep-08 2
80299 Quantitation of drug, not elsewhere specified 30-Sep-08 3
80400 ACTH stimulation panel; for adrenal insufficiency This panel must include the 30-Sep-08 1
following: Cortisol (82533 x 2)
80402 ACTH stimulation panel; for 21 hydroxylase deficiency This panel must include 30-Sep-08 1
the following: Cortisol (82533 x 2), 17 hydroxyprogesterone (83498 x 2)
80406 ACTH stimulation panel; for 3 beta-hydroxydehydrogenase deficiency This panel 30-Sep-08 1
must include the following: Cortisol (82533 x 2), 17 hydroxypregnenolone
(84143 x 2)
80408 Aldosterone suppression evaluation panel (eg, saline infusion) This panel must 30-Sep-08 1
include the following: Aldosterone (82088 x 2), Renin (84244 x 2)
80410 Calcitonin stimulation panel (eg, calcium, pentagastrin) This panel must include 30-Sep-08 1
the following: Calcitonin (82308 x 3)
80412 Corticotropic releasing hormone (CRH) stimulation panel This panel must include 30-Sep-08 1
the following: Cortisol (82533 x 6), Adrenocorticotropic hormone (ACTH) (82024
x 6)
80414 Chorionic gonadotropin stimulation panel; testosterone response This panel 30-Sep-08 1
must include the following: Testosterone (84403 x 2 on 3 pooled blood samples)
80415 Chorionic gonadotropin stimulation panel; estradiol response This panel must 30-Sep-08 1
include the following: Estradiol (82670 x 2 on 3 pooled blood samples)
80416 Renal vein renin stimulation panel (eg, captopril) This panel must include the 30-Sep-08 1
following: Renin (84244 x 6)
80417 Peripheral vein renin stimulation panel (eg, captopril) This panel must include 30-Sep-08 1
the following: Renin (84244 x 2)
80418 Combined rapid anterior pituitary evaluation panel This panel must include the 30-Sep-08 1
following: Adrenocorticotropic hormone (ACTH) (82024 x 4), Luteinizing hormone
(LH) (83002 x 4), Follicle stimulating hormone (FSH) (83001 x 4), Prolactin
(84146 x 4), Human growth hormone (HGH) (83003 x 4), Cortisol (82533 x 4),
Thyroid stimulating hormone (TSH) (84443 x 4)
80420 Dexamethasone suppression panel, 48 hour This panel must include the 30-Sep-08 1
following: Free cortisol, urine (82530 x 2), Cortisol (82533 x 2), Volume
measurement for timed collection (81050 x 2)
80422 Glucagon tolerance panel; for insulinoma This panel must include the following: 30-Sep-08 1
Glucose (82947 x 3), Insulin (83525 x 3)
80424 Glucagon tolerance panel; for pheochromocytoma This panel must include the 30-Sep-08 1
following: Catecholamines, fractionated (82384 x 2)
80426 Gonadotropin releasing hormone stimulation panel This panel must include the 30-Sep-08 1
following: Follicle stimulating hormone (FSH) (83001 x 4), Luteinizing hormone
(LH) (83002 x 4)
80428 Growth hormone stimulation panel (eg, arginine infusion, l-dopa administration) 30-Sep-08 1
This panel must include the following: Human growth hormone (HGH) (83003 x
4)
80430 Growth hormone suppression panel (glucose administration) This panel must 30-Sep-08 1
include the following: Glucose (82947 x 3), Human growth hormone (HGH)
(83003 x 4)
80432 Insulin-induced C-peptide suppression panel This panel must include the 30-Sep-08 1
following: Insulin (83525), C-peptide (84681 x 5), Glucose (82947 x 5)
80434 Insulin tolerance panel; for ACTH insufficiency This panel must include the 30-Sep-08 1
following: Cortisol (82533 x 5), Glucose (82947 x 5)
80435 Insulin tolerance panel; for growth hormone deficiency This panel must include 30-Sep-08 1
the following: Glucose (82947 x 5), Human growth hormone (HGH) (83003 x 5)
80436 Metyrapone panel This panel must include the following: Cortisol (82533 x 2), 11 30-Sep-08 1
deoxycortisol (82634 x 2)
80438 Thyrotropin releasing hormone (TRH) stimulation panel; 1 hour This panel must 30-Sep-08 1
include the following: Thyroid stimulating hormone (TSH) (84443 x 3)
80439 Thyrotropin releasing hormone (TRH) stimulation panel; 2 hour This panel must 30-Sep-08 1
include the following: Thyroid stimulating hormone (TSH) (84443 x 4)
80440 Thyrotropin releasing hormone (TRH) stimulation panel; for hyperprolactinemia 30-Sep-08 1
This panel must include the following: Prolactin (84146 x 3)
80500 Clinical pathology consultation; limited, without review of patient's history and 30-Sep-08 1
medical records
80502 Clinical pathology consultation; comprehensive, for a complex diagnostic 30-Sep-08 1
problem, with review of patient's history and medical records
81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, 30-Sep-08 2
ketones, leukocytes, nitrite, pH, protein, specific gravity, urobilinogen, any
number of these constituents; non-automated, with microscopy
number of these constituents; automated, with microscopy
number of these constituents; non-automated, without microscopy
number of these constituents; automated, without microscopy
81005 Urinalysis; qualitative or semiquantitative, except immunoassays 30-Sep-08 2

81007 Urinalysis; bacteriuria screen, except by culture or dipstick 30-Sep-08 1
81015 Urinalysis; microscopic only 30-Sep-08 1
81020 Urinalysis; 2 or 3 glass test 30-Sep-08 1
81025 Urine pregnancy test, by visual color comparison methods 30-Sep-08 1
81050 Volume measurement for timed collection, each 30-Sep-08 2
81099 Unlisted urinalysis procedure 30-Sep-08
82000 Acetaldehyde, blood 30-Sep-08 1

82003 Acetaminophen 30-Sep-08 2
82009 Acetone or other ketone bodies, serum; qualitative 30-Sep-08 1
82010 Acetone or other ketone bodies, serum; quantitative 30-Sep-08 4
82013 Acetylcholinesterase 30-Sep-08 1
82016 Acylcarnitines; qualitative, each specimen 30-Sep-08 1
82017 Acylcarnitines; quantitative, each specimen 30-Sep-08 1
82024 Adrenocorticotropic hormone (ACTH) 30-Sep-08
82030 Adenosine, 5-monophosphate, cyclic (cyclic AMP) 30-Sep-08 1
82040 Albumin; serum, plasma or whole blood 30-Sep-08 1
82042 Albumin; urine or other source, quantitative, each specimen 30-Sep-08 2
82043 Albumin; urine, microalbumin, quantitative 30-Sep-08 1
82044 Albumin; urine, microalbumin, semiquantitative (eg, reagent strip assay) 30-Sep-08 1
82045 Albumin; ischemia modified 30-Sep-08 1

82055 Alcohol (ethanol); any specimen except breath 30-Sep-08 2
82075 Alcohol (ethanol); breath 30-Sep-08 2
82085 Aldolase 30-Sep-08 1

82088 Aldosterone 30-Sep-08
82101 Alkaloids, urine, quantitative 30-Sep-08 1
82103 Alpha-1-antitrypsin; total 30-Sep-08 1
82104 Alpha-1-antitrypsin; phenotype 30-Sep-08 1
82105 Alpha-fetoprotein (AFP); serum 30-Sep-08 1
82106 Alpha-fetoprotein (AFP); amniotic fluid 30-Sep-08 4
82107 Alpha-fetoprotein (AFP); AFP-L3 fraction isoform and total AFP (including ratio) 30-Sep-08 1
82108 Aluminum 30-Sep-08 1

82120 Amines, vaginal fluid, qualitative 30-Sep-08 1
82127 Amino acids; single, qualitative, each specimen 30-Sep-08 2
82128 Amino acids; multiple, qualitative, each specimen 30-Sep-08 2
82131 Amino acids; single, quantitative, each specimen 30-Sep-08 3
82135 Aminolevulinic acid, delta (ALA) 30-Sep-08 1
82136 Amino acids, 2 to 5 amino acids, quantitative, each specimen 30-Sep-08 3
82139 Amino acids, 6 or more amino acids, quantitative, each specimen 30-Sep-08 3
82140 Ammonia 30-Sep-08 2
82143 Amniotic fluid scan (spectrophotometric) 30-Sep-08 2
82145 Amphetamine or methamphetamine 30-Sep-08 1
82150 Amylase 30-Sep-08 4
82154 Androstanediol glucuronide 30-Sep-08 1
82157 Androstenedione 30-Sep-08 1
82160 Androsterone 30-Sep-08 1
82163 Angiotensin II 30-Sep-08 1
82164 Angiotensin I - converting enzyme (ACE) 30-Sep-08 1
82172 Apolipoprotein, each 30-Sep-08 3
82175 Arsenic 30-Sep-08 2
82180 Ascorbic acid (Vitamin C), blood 30-Sep-08 1
82190 Atomic absorption spectroscopy, each analyte 30-Sep-08 4
82205 Barbiturates, not elsewhere specified 30-Sep-08 1
82232 Beta-2 microglobulin 30-Sep-08 2
82239 Bile acids; total 30-Sep-08 1
82240 Bile acids; cholylglycine 30-Sep-08 1
82247 Bilirubin; total 30-Sep-08 2
82248 Bilirubin; direct 30-Sep-08 2
82252 Bilirubin; feces, qualitative 30-Sep-08 1
82261 Biotinidase, each specimen 30-Sep-08 1
82270 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; feces, consecutive 30-Sep-08 1
collected specimens with single determination, for colorectal neoplasm
screening (ie, patient was provided 3 cards or single triple card for consecutive
collection)
82271 Blood, occult, by peroxidase activity (eg, guaiac), qualitative; other sources 30-Sep-08 1
82272 Blood, occult, by peroxidase activity (eg, guaiac), qualitative, feces, 1-3 30-Sep-08 1
simultaneous determinations, performed for other than colorectal neoplasm
screening
82274 Blood, occult, by fecal hemoglobin determination by immunoassay, qualitative, 30-Sep-08 1
feces, 1-3 simultaneous determinations
82286 Bradykinin 30-Sep-08 1
82300 Cadmium 30-Sep-08 1
82306 Vitamin D; 25 hydroxy, includes fraction(s), if performed 30-Sep-08 1
82307 Calciferol (Vitamin D) 30-Sep-08 14-Oct-12
82308 Calcitonin 30-Sep-08 3
82310 Calcium; total 30-Sep-08 2
82330 Calcium; ionized 30-Sep-08 2
82331 Calcium; after calcium infusion test 30-Sep-08 1
82340 Calcium; urine quantitative, timed specimen 30-Sep-08 1
82355 Calculus; qualitative analysis 30-Sep-08 3
82360 Calculus; quantitative analysis, chemical 30-Sep-08 3
82365 Calculus; infrared spectroscopy 30-Sep-08 3
82370 Calculus; X-ray diffraction 30-Sep-08 3
82373 Carbohydrate deficient transferrin 30-Sep-08 1
82374 Carbon dioxide (bicarbonate) 30-Sep-08 2
82375 Carboxyhemoglobin; quantitative 30-Sep-08 1
82376 Carboxyhemoglobin; qualitative 30-Sep-08
82378 Carcinoembryonic antigen (CEA) 30-Sep-08 2
82379 Carnitine (total and free), quantitative, each specimen 30-Sep-08 1
82380 Carotene 30-Sep-08 1
82382 Catecholamines; total urine 30-Sep-08 1
82383 Catecholamines; blood 30-Sep-08 1
82384 Catecholamines; fractionated 30-Sep-08 2
82387 Cathepsin-D 30-Sep-08 1
82390 Ceruloplasmin 30-Sep-08 1
82397 Chemiluminescent assay 30-Sep-08
82415 Chloramphenicol 30-Sep-08 1
82435 Chloride; blood 30-Sep-08 2
82436 Chloride; urine 30-Sep-08 1
82438 Chloride; other source 30-Sep-08 1
82441 Chlorinated hydrocarbons, screen 30-Sep-08 1
82465 Cholesterol, serum or whole blood, total 30-Sep-08 1
82480 Cholinesterase; serum 30-Sep-08 2
82482 Cholinesterase; RBC 30-Sep-08 1
82485 Chondroitin B sulfate, quantitative 30-Sep-08 1
82486 Chromatography, qualitative; column (eg, gas liquid or HPLC), analyte not 30-Sep-08 2
elsewhere specified
82487 Chromatography, qualitative; paper, 1-dimensional, analyte not elsewhere 30-Sep-08 2
specified
82488 Chromatography, qualitative; paper, 2-dimensional, analyte not elsewhere 30-Sep-08 1
specified
82489 Chromatography, qualitative; thin layer, analyte not elsewhere specified 30-Sep-08 2
82491 Chromatography, quantitative, column (eg, gas liquid or HPLC); single analyte 30-Sep-08
not elsewhere specified, single stationary and mobile phase
82492 Chromatography, quantitative, column (eg, gas liquid or HPLC); multiple 30-Sep-08 2
analytes, single stationary and mobile phase
82495 Chromium 30-Sep-08 1
82507 Citrate 30-Sep-08 1
82520 Cocaine or metabolite 30-Sep-08 2
82523 Collagen cross links, any method 30-Sep-08 1
82525 Copper 30-Sep-08 2
82528 Corticosterone 30-Sep-08 1
82530 Cortisol; free 30-Sep-08 2
82533 Cortisol; total 30-Sep-08
82540 Creatine 30-Sep-08 1
82541 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte 30-Sep-08
not elsewhere specified; qualitative, single stationary and mobile phase
82542 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte 30-Sep-08

not elsewhere specified; quantitative, single stationary and mobile phase
82543 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte 30-Sep-08 2

not elsewhere specified; stable isotope dilution, single analyte, quantitative,
single stationary and mobile phase
82544 Column chromatography/mass spectrometry (eg, GC/MS, or HPLC/MS), analyte 30-Sep-08 2
not elsewhere specified; stable isotope dilution, multiple analytes, quantitative,
single stationary and mobile phase
82550 Creatine kinase (CK), (CPK); total 30-Sep-08 3
82552 Creatine kinase (CK), (CPK); isoenzymes 30-Sep-08 3
82553 Creatine kinase (CK), (CPK); MB fraction only 30-Sep-08 3
82554 Creatine kinase (CK), (CPK); isoforms 30-Sep-08 1
82565 Creatinine; blood 30-Sep-08 2
82570 Creatinine; other source 30-Sep-08 3
82575 Creatinine; clearance 30-Sep-08 1
82585 Cryofibrinogen 30-Sep-08 1
82595 Cryoglobulin, qualitative or semi-quantitative (eg, cryocrit) 30-Sep-08 1
82600 Cyanide 30-Sep-08 1
82607 Cyanocobalamin (Vitamin B-12); 30-Sep-08 1
82608 Cyanocobalamin (Vitamin B-12); unsaturated binding capacity 30-Sep-08 1
82610 Cystatin C 30-Sep-08 1
82615 Cystine and homocystine, urine, qualitative 30-Sep-08 1
82626 Dehydroepiandrosterone (DHEA) 30-Sep-08 1
82627 Dehydroepiandrosterone-sulfate (DHEA-S) 30-Sep-08 1
82633 Desoxycorticosterone, 11- 30-Sep-08 1
82634 Deoxycortisol, 11- 30-Sep-08 2
82638 Dibucaine number 30-Sep-08 1
82646 Dihydrocodeinone 30-Sep-08 1
82649 Dihydromorphinone 30-Sep-08 1
82651 Dihydrotestosterone (DHT) 30-Sep-08 1
82652 Vitamin D; 1, 25 dihydroxy, includes fraction(s), if performed 30-Sep-08 1
82654 Dimethadione 30-Sep-08 1
82656 Elastase, pancreatic (EL-1), fecal, qualitative or semi-quantitative 30-Sep-08 1
82657 Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; 30-Sep-08 3
nonradioactive substrate, each specimen
82658 Enzyme activity in blood cells, cultured cells, or tissue, not elsewhere specified; 30-Sep-08 2
radioactive substrate, each specimen
82664 Electrophoretic technique, not elsewhere specified 30-Sep-08
82666 Epiandrosterone 30-Sep-08 1
82668 Erythropoietin 30-Sep-08 1
82670 Estradiol 30-Sep-08 2
82671 Estrogens; fractionated 30-Sep-08 1
82672 Estrogens; total 30-Sep-08 1
82677 Estriol 30-Sep-08 1
82679 Estrone 30-Sep-08 1
82690 Ethchlorvynol 30-Sep-08 1
82693 Ethylene glycol 30-Sep-08 2
82696 Etiocholanolone 30-Sep-08 1

82705 Fat or lipids, feces; qualitative 30-Sep-08 1
82710 Fat or lipids, feces; quantitative 30-Sep-08 1
82715 Fat differential, feces, quantitative 30-Sep-08 1
82725 Fatty acids, nonesterified 30-Sep-08 1
82726 Very long chain fatty acids 30-Sep-08 1
82728 Ferritin 30-Sep-08 1
82731 Fetal fibronectin, cervicovaginal secretions, semi-quantitative 30-Sep-08 1
82735 Fluoride 30-Sep-08 1
82742 Flurazepam 30-Sep-08 1
82746 Folic acid; serum 30-Sep-08 1
82747 Folic acid; RBC 30-Sep-08 1
82757 Fructose, semen 30-Sep-08 1
82759 Galactokinase, RBC 30-Sep-08 1
82760 Galactose 30-Sep-08 1
82775 Galactose-1-phosphate uridyl transferase; quantitative 30-Sep-08 1
82776 Galactose-1-phosphate uridyl transferase; screen 30-Sep-08 1
82784 Gammaglobulin (immunoglobulin); IgA, IgD, IgG, IgM, each 30-Sep-08 6
82785 Gammaglobulin (immunoglobulin); IgE 30-Sep-08 1
82787 Gammaglobulin (immunoglobulin); immunoglobulin subclasses (eg, IgG1, 2, 3, or 30-Sep-08 4
4), each
82800 Gases, blood, pH only 30-Sep-08
82803 Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including 30-Sep-08
calculated O2 saturation);
82805 Gases, blood, any combination of pH, pCO2, pO2, CO2, HCO3 (including 30-Sep-08
calculated O2 saturation); with O2 saturation, by direct measurement, except
pulse oximetry
82810 Gases, blood, O2 saturation only, by direct measurement, except pulse oximetry 30-Sep-08
82820 Hemoglobin-oxygen affinity (pO2 for 50% hemoglobin saturation with oxygen) 30-Sep-08 1
82926 Gastric acid, free and total, each specimen 30-Sep-08 14-Oct-12
82928 Gastric acid, free or total, each specimen 30-Sep-08 14-Oct-12
82930 Gastric acid analysis, includes pH if performed, each specimen 15-Oct-12
82938 Gastrin after secretin stimulation 30-Sep-08
82941 Gastrin 30-Sep-08 1
82943 Glucagon 30-Sep-08 1
82945 Glucose, body fluid, other than blood 30-Sep-08
82946 Glucagon tolerance test 30-Sep-08 1
82947 Glucose; quantitative, blood (except reagent strip) 30-Sep-08
82948 Glucose; blood, reagent strip 30-Sep-08
82950 Glucose; post glucose dose (includes glucose) 30-Sep-08 3
82951 Glucose; tolerance test (GTT), 3 specimens (includes glucose) 30-Sep-08 1
82952 Glucose; tolerance test, each additional beyond 3 specimens (List separately in 30-Sep-08 3
82953 Glucose; tolbutamide tolerance test 30-Sep-08 1
82955 Glucose-6-phosphate dehydrogenase (G6PD); quantitative 30-Sep-08 1
82960 Glucose-6-phosphate dehydrogenase (G6PD); screen 30-Sep-08 1
82962 Glucose, blood by glucose monitoring device(s) cleared by the FDA specifically 30-Sep-08
for home use
82963 Glucosidase, beta 30-Sep-08 1
82965 Glutamate dehydrogenase 30-Sep-08 1
82975 Glutamine (glutamic acid amide) 30-Sep-08 1
82977 Glutamyltransferase, gamma (GGT) 30-Sep-08 1
82978 Glutathione 30-Sep-08 1
82979 Glutathione reductase, RBC 30-Sep-08 1
82980 Glutethimide 30-Sep-08 1
82985 Glycated protein 30-Sep-08 1
83001 Gonadotropin; follicle stimulating hormone (FSH) 30-Sep-08
83002 Gonadotropin; luteinizing hormone (LH) 30-Sep-08
83003 Growth hormone, human (HGH) (somatotropin) 30-Sep-08
83008 Guanosine monophosphate (GMP), cyclic 30-Sep-08 1
83009 Helicobacter pylori, blood test analysis for urease activity, non-radioactive 30-Sep-08 1
isotope (eg, C-13)
83010 Haptoglobin; quantitative 30-Sep-08 1
83012 Haptoglobin; phenotypes 30-Sep-08 1
83013 Helicobacter pylori; breath test analysis for urease activity, non-radioactive 30-Sep-08 1
isotope (eg, C-13)
83014 Helicobacter pylori; drug administration 30-Sep-08 1
83015 Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); 30-Sep-08 1
screen
83018 Heavy metal (eg, arsenic, barium, beryllium, bismuth, antimony, mercury); 30-Sep-08 7
quantitative, each
83020 Hemoglobin fractionation and quantitation; electrophoresis (eg, A2, S, C, and/or 30-Sep-08 2
F)
83021 Hemoglobin fractionation and quantitation; chromatography (eg, A2, S, C, and/or 30-Sep-08 2
F)
83026 Hemoglobin; by copper sulfate method, non-automated 30-Sep-08 1
83030 Hemoglobin; F (fetal), chemical 30-Sep-08 1
83033 Hemoglobin; F (fetal), qualitative 30-Sep-08 1
83036 Hemoglobin; glycosylated (A1C) 30-Sep-08 1
83037 Hemoglobin; glycosylated (A1C) by device cleared by FDA for home use 30-Sep-08 1
83045 Hemoglobin; methemoglobin, qualitative 30-Sep-08 1

83050 Hemoglobin; methemoglobin, quantitative 30-Sep-08 1
83051 Hemoglobin; plasma 30-Sep-08 1
83055 Hemoglobin; sulfhemoglobin, qualitative 30-Sep-08 1
83060 Hemoglobin; sulfhemoglobin, quantitative 30-Sep-08 1
83065 Hemoglobin; thermolabile 30-Sep-08 1
83068 Hemoglobin; unstable, screen 30-Sep-08 1
83069 Hemoglobin; urine 30-Sep-08 1
83070 Hemosiderin; qualitative 30-Sep-08 1
83071 Hemosiderin; quantitative 30-Sep-08 1
83080 b-Hexosaminidase, each assay 30-Sep-08 2
83088 Histamine 30-Sep-08 1
83090 Homocysteine 30-Sep-08 2
83150 Homovanillic acid (HVA) 30-Sep-08 1
83491 Hydroxycorticosteroids, 17- (17-OHCS) 30-Sep-08 1
83497 Hydroxyindolacetic acid, 5-(HIAA) 30-Sep-08 1
83498 Hydroxyprogesterone, 17-d 30-Sep-08 2
83499 Hydroxyprogesterone, 20- 30-Sep-08 1
83500 Hydroxyproline; free 30-Sep-08 1
83505 Hydroxyproline; total 30-Sep-08 1
83516 Immunoassay for analyte other than infectious agent antibody or infectious 30-Sep-08
agent antigen; qualitative or semiquantitative, multiple step method
83518 Immunoassay for analyte other than infectious agent antibody or infectious 30-Sep-08 2
agent antigen; qualitative or semiquantitative, single step method (eg, reagent
strip)
agent antigen; quantitative, by radioimmunoassay (eg, RIA)
agent antigen; quantitative, not otherwise specified
83525 Insulin; total 30-Sep-08
83527 Insulin; free 30-Sep-08 1
83528 Intrinsic factor 30-Sep-08 1
83540 Iron 30-Sep-08 2
83550 Iron binding capacity 30-Sep-08 1
83570 Isocitric dehydrogenase (IDH) 30-Sep-08 1
83582 Ketogenic steroids, fractionation 30-Sep-08 1
83586 Ketosteroids, 17- (17-KS); total 30-Sep-08 1
83593 Ketosteroids, 17- (17-KS); fractionation 30-Sep-08 1
83605 Lactate (lactic acid) 30-Sep-08 3
83615 Lactate dehydrogenase (LD), (LDH); 30-Sep-08 2
83625 Lactate dehydrogenase (LD), (LDH); isoenzymes, separation and quantitation 30-Sep-08 1
83630 Lactoferrin, fecal; qualitative 30-Sep-08 1

83631 Lactoferrin, fecal; quantitative 30-Sep-08 1
83632 Lactogen, human placental (HPL) human chorionic somatomammotropin 30-Sep-08 1
83633 Lactose, urine; qualitative 30-Sep-08 1

83634 Lactose, urine; quantitative 30-Sep-08 1
83655 Lead 30-Sep-08 2
83661 Fetal lung maturity assessment; lecithin sphingomyelin (L/S) ratio 30-Sep-08 4
83662 Fetal lung maturity assessment; foam stability test 30-Sep-08 4
83663 Fetal lung maturity assessment; fluorescence polarization 30-Sep-08 4
83664 Fetal lung maturity assessment; lamellar body density 30-Sep-08 4
83670 Leucine aminopeptidase (LAP) 30-Sep-08 1
83690 Lipase 30-Sep-08 2
83695 Lipoprotein (a) 30-Sep-08 1
83698 Lipoprotein-associated phospholipase A2 (Lp-PLA2) 30-Sep-08 1
83700 Lipoprotein, blood; electrophoretic separation and quantitation 30-Sep-08 1
83701 Lipoprotein, blood; high resolution fractionation and quantitation of lipoproteins 30-Sep-08 1
including lipoprotein subclasses when performed (eg, electrophoresis,
ultracentrifugation)
83704 Lipoprotein, blood; quantitation of lipoprotein particle numbers and lipoprotein 30-Sep-08 1
particle subclasses (eg, by nuclear magnetic resonance spectroscopy)
83718 Lipoprotein, direct measurement; high density cholesterol (HDL cholesterol) 30-Sep-08 1
83719 Lipoprotein, direct measurement; VLDL cholesterol 30-Sep-08 1

83721 Lipoprotein, direct measurement; LDL cholesterol 30-Sep-08 1
83727 Luteinizing releasing factor (LRH) 30-Sep-08 1
83735 Magnesium 30-Sep-08 4
83775 Malate dehydrogenase 30-Sep-08 1
83785 Manganese 30-Sep-08 1
83788 Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not 30-Sep-08 3
elsewhere specified; qualitative, each specimen
83789 Mass spectrometry and tandem mass spectrometry (MS, MS/MS), analyte not 30-Sep-08 2
elsewhere specified; quantitative, each specimen
83805 Meprobamate 30-Sep-08 1
83825 Mercury, quantitative 30-Sep-08 2
83835 Metanephrines 30-Sep-08 2
83840 Methadone 30-Sep-08 2
83857 Methemalbumin 30-Sep-08 1
83858 Methsuximide 30-Sep-08 1
83861 Microfluidic analysis utilizing an integrated collection and analysis device, tear 15-Oct-12 2
osmolarity
83864 Mucopolysaccharides, acid; quantitative 30-Sep-08 1
83866 Mucopolysaccharides, acid; screen 30-Sep-08 1
83872 Mucin, synovial fluid (Ropes test) 30-Sep-08 2
83873 Myelin basic protein, cerebrospinal fluid 30-Sep-08 1
83874 Myoglobin 30-Sep-08 2
83876 Myeloperoxidase (MPO) 15-Oct-12
83880 Natriuretic peptide 30-Sep-08 1
83883 Nephelometry, each analyte not elsewhere specified 30-Sep-08
83885 Nickel 30-Sep-08 2
83887 Nicotine 30-Sep-08 2
83890 Molecular diagnostics; molecular isolation or extraction, each nucleic acid type 30-Sep-08
(ie, DNA or RNA)
83891 Molecular diagnostics; isolation or extraction of highly purified nucleic acid, each 30-Sep-08
nucleic acid type (ie, DNA or RNA)
83892 Molecular diagnostics; enzymatic digestion, each enzyme treatment 30-Sep-08
83893 Molecular diagnostics; dot/slot blot production, each nucleic acid preparation 30-Sep-08
83894 Molecular diagnostics; separation by gel electrophoresis (eg, agarose, 30-Sep-08

polyacrylamide), each nucleic acid preparation
83896 Molecular diagnostics; nucleic acid probe, each 30-Sep-08
83897 Molecular diagnostics; nucleic acid transfer (eg, Southern, Northern), each 30-Sep-08
nucleic acid preparation
83898 Molecular diagnostics; amplification, target, each nucleic acid sequence 30-Sep-08
83900 Molecular diagnostics; amplification, target, multiplex, first 2 nucleic acid 30-Sep-08
sequences
83901 Molecular diagnostics; amplification, target, multiplex, each additional nucleic 30-Sep-08
acid sequence beyond 2 (List separately in addition to code for primary
procedure)
83902 Molecular diagnostics; reverse transcription 30-Sep-08
83903 Molecular diagnostics; mutation scanning, by physical properties (eg, single 30-Sep-08
strand conformational polymorphisms [SSCP], heteroduplex, denaturing gradient
gel electrophoresis [DGGE], RNA'ase A), single segment, each
83904 Molecular diagnostics; mutation identification by sequencing, single segment, 30-Sep-08
each segment
83905 Molecular diagnostics; mutation identification by allele specific transcription, 30-Sep-08
single segment, each segment
83906 Molecular diagnostics; mutation identification by allele specific translation, 30-Sep-08
single segment, each segment
83907 Molecular diagnostics; lysis of cells prior to nucleic acid extraction (eg, stool 30-Sep-08
specimens, paraffin embedded tissue), each specimen
83908 Molecular diagnostics; amplification, signal, each nucleic acid sequence 30-Sep-08
83909 Molecular diagnostics; separation and identification by high resolution technique 30-Sep-08
(eg, capillary electrophoresis), each nucleic acid preparation
83912 Molecular diagnostics; interpretation and report 30-Sep-08 1

83913 Molecular diagnostics; RNA stabilization 30-Sep-08
83914 Mutation identification by enzymatic ligation or primer extension, single 30-Sep-08
segment, each segment (eg, oligonucleotide ligation assay [OLA], single base
chain extension [SBCE], or allele-specific primer extension [ASPE])
83915 Nucleotidase 5'- 30-Sep-08 1

83916 Oligoclonal immune (oligoclonal bands) 30-Sep-08 2
83918 Organic acids; total, quantitative, each specimen 30-Sep-08 2
83919 Organic acids; qualitative, each specimen 30-Sep-08 1
83921 Organic acid, single, quantitative 30-Sep-08 2
83925 Opiate(s), drug and metabolites, each procedure 30-Sep-08 4
83930 Osmolality; blood 30-Sep-08 2
83935 Osmolality; urine 30-Sep-08 2
83937 Osteocalcin (bone g1a protein) 30-Sep-08 1
83945 Oxalate 30-Sep-08 2
83950 Oncoprotein; HER-2/neu 30-Sep-08 1
83951 Oncoprotein; des-gamma-carboxy-prothrombin (DCP) 15-Oct-12 1
83970 Parathormone (parathyroid hormone) 30-Sep-08 2
83986 pH; body fluid, not otherwise specified 30-Sep-08 2
83987 pH; exhaled breath condensate 15-Oct-12
83992 Phencyclidine (PCP) 30-Sep-08 2
83993 Calprotectin, fecal 30-Sep-08 1
84022 Phenothiazine 30-Sep-08 2
84030 Phenylalanine (PKU), blood 30-Sep-08 1
84035 Phenylketones, qualitative 30-Sep-08 1
84060 Phosphatase, acid; total 30-Sep-08 1
84061 Phosphatase, acid; forensic examination 30-Sep-08 1
84066 Phosphatase, acid; prostatic 30-Sep-08 1
84075 Phosphatase, alkaline; 30-Sep-08 2
84078 Phosphatase, alkaline; heat stable (total not included) 30-Sep-08 1
84080 Phosphatase, alkaline; isoenzymes 30-Sep-08 1
84081 Phosphatidylglycerol 30-Sep-08 1
84085 Phosphogluconate, 6-, dehydrogenase, RBC 30-Sep-08 1
84087 Phosphohexose isomerase 30-Sep-08 1
84100 Phosphorus inorganic (phosphate); 30-Sep-08 3
84105 Phosphorus inorganic (phosphate); urine 30-Sep-08 1
84106 Porphobilinogen, urine; qualitative 30-Sep-08 1
84110 Porphobilinogen, urine; quantitative 30-Sep-08 1
84112 Placental alpha microglobulin-1 (PAMG-1), cervicovaginal secretion, qualitative 15-Oct-12 1
84119 Porphyrins, urine; qualitative 30-Sep-08 1

84120 Porphyrins, urine; quantitation and fractionation 30-Sep-08 1
84126 Porphyrins, feces; quantitative 30-Sep-08 1
84127 Porphyrins, feces; qualitative 30-Sep-08 1
84132 Potassium; serum, plasma or whole blood 30-Sep-08 3
84133 Potassium; urine 30-Sep-08 2
84134 Prealbumin 30-Sep-08 1
84135 Pregnanediol 30-Sep-08 1
84138 Pregnanetriol 30-Sep-08 1
84140 Pregnenolone 30-Sep-08 1
84143 17-hydroxypregnenolone 30-Sep-08 2
84144 Progesterone 30-Sep-08 1
84145 Procalcitonin (PCT) 15-Oct-12
84146 Prolactin 30-Sep-08 3
84150 Prostaglandin, each 30-Sep-08 2
84152 Prostate specific antigen (PSA); complexed (direct measurement) 30-Sep-08 1
84153 Prostate specific antigen (PSA); total 30-Sep-08 1
84154 Prostate specific antigen (PSA); free 30-Sep-08 1
84155 Protein, total, except by refractometry; serum, plasma or whole blood 30-Sep-08 1
84156 Protein, total, except by refractometry; urine 30-Sep-08 1

84157 Protein, total, except by refractometry; other source (eg, synovial fluid, 30-Sep-08 3
cerebrospinal fluid)
84160 Protein, total, by refractometry, any source 30-Sep-08 2
84163 Pregnancy-associated plasma protein-A (PAPP-A) 30-Sep-08 1
84165 Protein; electrophoretic fractionation and quantitation, serum 30-Sep-08 1
84166 Protein; electrophoretic fractionation and quantitation, other fluids with 30-Sep-08 2
concentration (eg, urine, CSF)
84181 Protein; Western Blot, with interpretation and report, blood or other body fluid 30-Sep-08
84182 Protein; Western Blot, with interpretation and report, blood or other body fluid, 30-Sep-08
immunological probe for band identification, each
84202 Protoporphyrin, RBC; quantitative 30-Sep-08 1
84203 Protoporphyrin, RBC; screen 30-Sep-08 1
84206 Proinsulin 30-Sep-08 1
84207 Pyridoxal phosphate (Vitamin B-6) 30-Sep-08 1
84210 Pyruvate 30-Sep-08 2
84220 Pyruvate kinase 30-Sep-08 1
84228 Quinine 30-Sep-08 1
84233 Receptor assay; estrogen 30-Sep-08 2
84234 Receptor assay; progesterone 30-Sep-08 2
84235 Receptor assay; endocrine, other than estrogen or progesterone (specify 30-Sep-08 1
hormone)
84238 Receptor assay; non-endocrine (specify receptor) 30-Sep-08 3
84244 Renin 30-Sep-08
84252 Riboflavin (Vitamin B-2) 30-Sep-08 1
84255 Selenium 30-Sep-08 2
84260 Serotonin 30-Sep-08 1
84270 Sex hormone binding globulin (SHBG) 30-Sep-08 1
84275 Sialic acid 30-Sep-08 1
84285 Silica 30-Sep-08 1
84295 Sodium; serum, plasma or whole blood 30-Sep-08 3
84300 Sodium; urine 30-Sep-08 2
84302 Sodium; other source 30-Sep-08 1
84305 Somatomedin 30-Sep-08 1
84307 Somatostatin 30-Sep-08 1
84311 Spectrophotometry, analyte not elsewhere specified 30-Sep-08 2
84315 Specific gravity (except urine) 30-Sep-08 2
84375 Sugars, chromatographic, TLC or paper chromatography 30-Sep-08 1
84376 Sugars (mono-, di-, and oligosaccharides); single qualitative, each specimen 30-Sep-08 1
84377 Sugars (mono-, di-, and oligosaccharides); multiple qualitative, each specimen 30-Sep-08 1
84378 Sugars (mono-, di-, and oligosaccharides); single quantitative, each specimen 30-Sep-08 2
84379 Sugars (mono-, di-, and oligosaccharides); multiple quantitative, each specimen 30-Sep-08 1
84392 Sulfate, urine 30-Sep-08 1

84402 Testosterone; free 30-Sep-08 1
84403 Testosterone; total 30-Sep-08 2
84425 Thiamine (Vitamin B-1) 30-Sep-08 1
84430 Thiocyanate 30-Sep-08 1
84431 Thromboxane metabolite(s), including thromboxane if performed, urine 15-Oct-12
84432 Thyroglobulin 30-Sep-08 1

84436 Thyroxine; total 30-Sep-08 1
84437 Thyroxine; requiring elution (eg, neonatal) 30-Sep-08 1
84439 Thyroxine; free 30-Sep-08 1
84442 Thyroxine binding globulin (TBG) 30-Sep-08 1
84443 Thyroid stimulating hormone (TSH) 30-Sep-08
84445 Thyroid stimulating immune globulins (TSI) 30-Sep-08 1
84446 Tocopherol alpha (Vitamin E) 30-Sep-08 1
84449 Transcortin (cortisol binding globulin) 30-Sep-08 1
84450 Transferase; aspartate amino (AST) (SGOT) 30-Sep-08 1
84460 Transferase; alanine amino (ALT) (SGPT) 30-Sep-08 1
84466 Transferrin 30-Sep-08 1
84478 Triglycerides 30-Sep-08 1
84479 Thyroid hormone (T3 or T4) uptake or thyroid hormone binding ratio (THBR) 30-Sep-08 1
84480 Triiodothyronine T3; total (TT-3) 30-Sep-08 1

84481 Triiodothyronine T3; free 30-Sep-08 1
84482 Triiodothyronine T3; reverse 30-Sep-08 1
84484 Troponin, quantitative 30-Sep-08 2
84485 Trypsin; duodenal fluid 30-Sep-08 1
84488 Trypsin; feces, qualitative 30-Sep-08 1
84490 Trypsin; feces, quantitative, 24-hour collection 30-Sep-08 1
84510 Tyrosine 30-Sep-08 1
84512 Troponin, qualitative 30-Sep-08 1
84520 Urea nitrogen; quantitative 30-Sep-08 4
84525 Urea nitrogen; semiquantitative (eg, reagent strip test) 30-Sep-08 1
84540 Urea nitrogen, urine 30-Sep-08 2
84545 Urea nitrogen, clearance 30-Sep-08 1
84550 Uric acid; blood 30-Sep-08 1
84560 Uric acid; other source 30-Sep-08 2
84577 Urobilinogen, feces, quantitative 30-Sep-08 1
84578 Urobilinogen, urine; qualitative 30-Sep-08 1
84580 Urobilinogen, urine; quantitative, timed specimen 30-Sep-08 1
84583 Urobilinogen, urine; semiquantitative 30-Sep-08 1
84585 Vanillylmandelic acid (VMA), urine 30-Sep-08 1
84586 Vasoactive intestinal peptide (VIP) 30-Sep-08 1
84588 Vasopressin (antidiuretic hormone, ADH) 30-Sep-08 2
84590 Vitamin A 30-Sep-08 1
84591 Vitamin, not otherwise specified 30-Sep-08 1
84597 Vitamin K 30-Sep-08 1
84600 Volatiles (eg, acetic anhydride, carbon tetrachloride, dichloroethane, 30-Sep-08 2
dichloromethane, diethylether, isopropyl alcohol, methanol)
84620 Xylose absorption test, blood and/or urine 30-Sep-08 1
84630 Zinc 30-Sep-08 2
84681 C-peptide 30-Sep-08
84702 Gonadotropin, chorionic (hCG); quantitative 30-Sep-08 2
84703 Gonadotropin, chorionic (hCG); qualitative 30-Sep-08 1
84704 Gonadotropin, chorionic (hCG); free beta chain 30-Sep-08 1
84830 Ovulation tests, by visual color comparison methods for human luteinizing 30-Sep-08 1
hormone
84999 Unlisted chemistry procedure 30-Sep-08
85002 Bleeding time 30-Sep-08 1

85004 Blood count; automated differential WBC count 30-Sep-08 2
85007 Blood count; blood smear, microscopic examination with manual differential 30-Sep-08 1
WBC count
85008 Blood count; blood smear, microscopic examination without manual differential 30-Sep-08 1
WBC count
85009 Blood count; manual differential WBC count, buffy coat 30-Sep-08 1
85013 Blood count; spun microhematocrit 30-Sep-08 2
85014 Blood count; hematocrit (Hct) 30-Sep-08 2
85018 Blood count; hemoglobin (Hgb) 30-Sep-08 2
85025 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet 30-Sep-08 2
count) and automated differential WBC count
85027 Blood count; complete (CBC), automated (Hgb, Hct, RBC, WBC and platelet 30-Sep-08
count)
85032 Blood count; manual cell count (erythrocyte, leukocyte, or platelet) each 30-Sep-08 3
85041 Blood count; red blood cell (RBC), automated 30-Sep-08 2

85044 Blood count; reticulocyte, manual 30-Sep-08 1
85045 Blood count; reticulocyte, automated 30-Sep-08 1
85046 Blood count; reticulocytes, automated, including 1 or more cellular parameters 30-Sep-08 1
(eg, reticulocyte hemoglobin content [CHr], immature reticulocyte fraction [IRF],
reticulocyte volume [MRV], RNA content), direct measurement
85048 Blood count; leukocyte (WBC), automated 30-Sep-08 2

85049 Blood count; platelet, automated 30-Sep-08 2
85055 Reticulated platelet assay 30-Sep-08 1
85060 Blood smear, peripheral, interpretation by physician with written report 30-Sep-08 1
85097 Bone marrow, smear interpretation 30-Sep-08 2

85130 Chromogenic substrate assay 30-Sep-08 2
85170 Clot retraction 30-Sep-08 1
85175 Clot lysis time, whole blood dilution 30-Sep-08 1
85210 Clotting; factor II, prothrombin, specific 30-Sep-08 2
85220 Clotting; factor V (AcG or proaccelerin), labile factor 30-Sep-08 2
85230 Clotting; factor VII (proconvertin, stable factor) 30-Sep-08 2
85240 Clotting; factor VIII (AHG), 1-stage 30-Sep-08 2
85244 Clotting; factor VIII related antigen 30-Sep-08 2
85245 Clotting; factor VIII, VW factor, ristocetin cofactor 30-Sep-08 2
85246 Clotting; factor VIII, VW factor antigen 30-Sep-08 2
85247 Clotting; factor VIII, von Willebrand factor, multimetric analysis 30-Sep-08 2
85250 Clotting; factor IX (PTC or Christmas) 30-Sep-08 2
85260 Clotting; factor X (Stuart-Prower) 30-Sep-08 2
85270 Clotting; factor XI (PTA) 30-Sep-08 2
85280 Clotting; factor XII (Hageman) 30-Sep-08 2
85290 Clotting; factor XIII (fibrin stabilizing) 30-Sep-08 2
85291 Clotting; factor XIII (fibrin stabilizing), screen solubility 30-Sep-08 2
85292 Clotting; prekallikrein assay (Fletcher factor assay) 30-Sep-08 2
85293 Clotting; high molecular weight kininogen assay (Fitzgerald factor assay) 30-Sep-08 2
85300 Clotting inhibitors or anticoagulants; antithrombin III, activity 30-Sep-08 2

85301 Clotting inhibitors or anticoagulants; antithrombin III, antigen assay 30-Sep-08 2
85302 Clotting inhibitors or anticoagulants; protein C, antigen 30-Sep-08 2
85303 Clotting inhibitors or anticoagulants; protein C, activity 30-Sep-08 2
85305 Clotting inhibitors or anticoagulants; protein S, total 30-Sep-08 2
85306 Clotting inhibitors or anticoagulants; protein S, free 30-Sep-08 2
85307 Activated Protein C (APC) resistance assay 30-Sep-08 2
85335 Factor inhibitor test 30-Sep-08 2
85337 Thrombomodulin 30-Sep-08 1
85345 Coagulation time; Lee and White 30-Sep-08 2
85347 Coagulation time; activated 30-Sep-08
85348 Coagulation time; other methods 30-Sep-08 1
85360 Euglobulin lysis 30-Sep-08 1
85362 Fibrin(ogen) degradation (split) products (FDP) (FSP); agglutination slide, 30-Sep-08 2
semiquantitative
85366 Fibrin(ogen) degradation (split) products (FDP) (FSP); paracoagulation 30-Sep-08 2
85370 Fibrin(ogen) degradation (split) products (FDP) (FSP); quantitative 30-Sep-08 2
85378 Fibrin degradation products, D-dimer; qualitative or semiquantitative 30-Sep-08 2
85379 Fibrin degradation products, D-dimer; quantitative 30-Sep-08 2
85380 Fibrin degradation products, D-dimer; ultrasensitive (eg, for evaluation for 30-Sep-08 2
venous thromboembolism), qualitative or semiquantitative
85384 Fibrinogen; activity 30-Sep-08 2

85385 Fibrinogen; antigen 30-Sep-08 1
85390 Fibrinolysins or coagulopathy screen, interpretation and report 30-Sep-08 3
85396 Coagulation/fibrinolysis assay, whole blood (eg, viscoelastic clot assessment), 30-Sep-08 1
including use of any pharmacologic additive(s), as indicated, including
interpretation and written report, per day
85397 Coagulation and fibrinolysis, functional activity, not otherwise specified (eg, 15-Oct-12
ADAMTS-13), each analyte
85400 Fibrinolytic factors and inhibitors; plasmin 30-Sep-08 2
85410 Fibrinolytic factors and inhibitors; alpha-2 antiplasmin 30-Sep-08 2
85415 Fibrinolytic factors and inhibitors; plasminogen activator 30-Sep-08 2
85420 Fibrinolytic factors and inhibitors; plasminogen, except antigenic assay 30-Sep-08 2
85421 Fibrinolytic factors and inhibitors; plasminogen, antigenic assay 30-Sep-08 2

85441 Heinz bodies; direct 30-Sep-08 1
85445 Heinz bodies; induced, acetyl phenylhydrazine 30-Sep-08 1
85460 Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; differential lysis 30-Sep-08 1
(Kleihauer-Betke)
85461 Hemoglobin or RBCs, fetal, for fetomaternal hemorrhage; rosette 30-Sep-08 1
85475 Hemolysin, acid 30-Sep-08 1
85520 Heparin assay 30-Sep-08
85525 Heparin neutralization 30-Sep-08 2
85530 Heparin-protamine tolerance test 30-Sep-08 1
85536 Iron stain, peripheral blood 30-Sep-08 1
85540 Leukocyte alkaline phosphatase with count 30-Sep-08 1
85547 Mechanical fragility, RBC 30-Sep-08 1
85549 Muramidase 30-Sep-08 1
85555 Osmotic fragility, RBC; unincubated 30-Sep-08 1
85557 Osmotic fragility, RBC; incubated 30-Sep-08 1
85576 Platelet, aggregation (in vitro), each agent 30-Sep-08
85597 Phospholipid neutralization; platelet 30-Sep-08 1
85598 Phospholipid neutralization; hexagonal phospholipid 15-Oct-12 1
85610 Prothrombin time; 30-Sep-08
85611 Prothrombin time; substitution, plasma fractions, each 30-Sep-08 2
85612 Russell viper venom time (includes venom); undiluted 30-Sep-08 1
85613 Russell viper venom time (includes venom); diluted 30-Sep-08 1
85635 Reptilase test 30-Sep-08 1
85651 Sedimentation rate, erythrocyte; non-automated 30-Sep-08 1
85652 Sedimentation rate, erythrocyte; automated 30-Sep-08 1
85660 Sickling of RBC, reduction 30-Sep-08 1
85670 Thrombin time; plasma 30-Sep-08 2
85675 Thrombin time; titer 30-Sep-08 1
85705 Thromboplastin inhibition, tissue 30-Sep-08 1
85730 Thromboplastin time, partial (PTT); plasma or whole blood 30-Sep-08
85732 Thromboplastin time, partial (PTT); substitution, plasma fractions, each 30-Sep-08 4
85810 Viscosity 30-Sep-08 2

85999 Unlisted hematology and coagulation procedure 30-Sep-08
86000 Agglutinins, febrile (eg, Brucella, Francisella, Murine typhus, Q fever, Rocky 30-Sep-08
Mountain spotted fever, scrub typhus), each antigen
86001 Allergen specific IgG quantitative or semiquantitative, each allergen 30-Sep-08
86003 Allergen specific IgE; quantitative or semiquantitative, each allergen 30-Sep-08
86005 Allergen specific IgE; qualitative, multiallergen screen (dipstick, paddle, or disk) 30-Sep-08
86021 Antibody identification; leukocyte antibodies 30-Sep-08 1

86022 Antibody identification; platelet antibodies 30-Sep-08 1
86023 Antibody identification; platelet associated immunoglobulin assay 30-Sep-08 2
86038 Antinuclear antibodies (ANA); 30-Sep-08 1
86039 Antinuclear antibodies (ANA); titer 30-Sep-08 1
86060 Antistreptolysin 0; titer 30-Sep-08 1
86063 Antistreptolysin 0; screen 30-Sep-08 1
86077 Blood bank physician services; difficult cross match and/or evaluation of irregular 30-Sep-08 1
antibody(s), interpretation and written report
86078 Blood bank physician services; investigation of transfusion reaction including 30-Sep-08 1
suspicion of transmissible disease, interpretation and written report
86079 Blood bank physician services; authorization for deviation from standard blood 30-Sep-08 1
banking procedures (eg, use of outdated blood, transfusion of Rh incompatible
units), with written report
86140 C-reactive protein; 30-Sep-08 1
86141 C-reactive protein; high sensitivity (hsCRP) 30-Sep-08 1
86146 Beta 2 Glycoprotein I antibody, each 30-Sep-08 3
86147 Cardiolipin (phospholipid) antibody, each Ig class 30-Sep-08 4
86148 Anti-phosphatidylserine (phospholipid) antibody 30-Sep-08 1
86155 Chemotaxis assay, specify method 30-Sep-08 1
86156 Cold agglutinin; screen 30-Sep-08 1
86157 Cold agglutinin; titer 30-Sep-08 1
86160 Complement; antigen, each component 30-Sep-08 4
86161 Complement; functional activity, each component 30-Sep-08 3
86162 Complement; total hemolytic (CH50) 30-Sep-08 1
86171 Complement fixation tests, each antigen 30-Sep-08 2
86185 Counterimmunoelectrophoresis, each antigen 30-Sep-08
86200 Cyclic citrullinated peptide (CCP), antibody 30-Sep-08 1
86215 Deoxyribonuclease, antibody 30-Sep-08 1
86225 Deoxyribonucleic acid (DNA) antibody; native or double stranded 30-Sep-08 1
86226 Deoxyribonucleic acid (DNA) antibody; single stranded 30-Sep-08 1
86235 Extractable nuclear antigen, antibody to, any method (eg, nRNP, SS-A, SS-B, Sm, 30-Sep-08
RNP, Sc170, J01), each antibody
86243 Fc receptor 30-Sep-08 1
86255 Fluorescent noninfectious agent antibody; screen, each antibody 30-Sep-08
86256 Fluorescent noninfectious agent antibody; titer, each antibody 30-Sep-08
86277 Growth hormone, human (HGH), antibody 30-Sep-08 1
86280 Hemagglutination inhibition test (HAI) 30-Sep-08 1
86294 Immunoassay for tumor antigen, qualitative or semiquantitative (eg, bladder 30-Sep-08 1
tumor antigen)
86300 Immunoassay for tumor antigen, quantitative; CA 15-3 (27.29) 30-Sep-08 2
86301 Immunoassay for tumor antigen, quantitative; CA 19-9 30-Sep-08 1
86304 Immunoassay for tumor antigen, quantitative; CA 125 30-Sep-08 1
86305 Human epididymis protein 4 (HE4) 15-Oct-12
86308 Heterophile antibodies; screening 30-Sep-08 1
86309 Heterophile antibodies; titer 30-Sep-08 1
86310 Heterophile antibodies; titers after absorption with beef cells and guinea pig 30-Sep-08 1
kidney
86316 Immunoassay for tumor antigen, other antigen, quantitative (eg, CA 50, 72-4, 30-Sep-08 3
549), each
86317 Immunoassay for infectious agent antibody, quantitative, not otherwise specified 30-Sep-08
86318 Immunoassay for infectious agent antibody, qualitative or semiquantitative, 30-Sep-08

single step method (eg, reagent strip)
86320 Immunoelectrophoresis; serum 30-Sep-08 1
86325 Immunoelectrophoresis; other fluids (eg, urine, cerebrospinal fluid) with 30-Sep-08 2
concentration
86327 Immunoelectrophoresis; crossed (2-dimensional assay) 30-Sep-08 1
86329 Immunodiffusion; not elsewhere specified 30-Sep-08
86331 Immunodiffusion; gel diffusion, qualitative (Ouchterlony), each antigen or 30-Sep-08
antibody
86332 Immune complex assay 30-Sep-08 1
86334 Immunofixation electrophoresis; serum 30-Sep-08 1
86335 Immunofixation electrophoresis; other fluids with concentration (eg, urine, CSF) 30-Sep-08 2
86336 Inhibin A 30-Sep-08 1

86337 Insulin antibodies 30-Sep-08 1
86340 Intrinsic factor antibodies 30-Sep-08 1
86341 Islet cell antibody 30-Sep-08 1
86343 Leukocyte histamine release test (LHR) 30-Sep-08 1
86344 Leukocyte phagocytosis 30-Sep-08 1
86352 Cellular function assay involving stimulation (eg, mitogen or antigen) and 15-Oct-12
detection of biomarker (eg, ATP)
86353 Lymphocyte transformation, mitogen (phytomitogen) or antigen induced 30-Sep-08
blastogenesis
86355 B cells, total count 30-Sep-08 1
86356 Mononuclear cell antigen, quantitative (eg, flow cytometry), not otherwise 30-Sep-08
specified, each antigen
86357 Natural killer (NK) cells, total count 30-Sep-08 1
86359 T cells; total count 30-Sep-08 1
86360 T cells; absolute CD4 and CD8 count, including ratio 30-Sep-08 1
86361 T cells; absolute CD4 count 30-Sep-08 1
86367 Stem cells (ie, CD34), total count 30-Sep-08 1
86376 Microsomal antibodies (eg, thyroid or liver-kidney), each 30-Sep-08 2
86378 Migration inhibitory factor test (MIF) 30-Sep-08 1
86382 Neutralization test, viral 30-Sep-08 3
86384 Nitroblue tetrazolium dye test (NTD) 30-Sep-08 1
86403 Particle agglutination; screen, each antibody 30-Sep-08
86406 Particle agglutination; titer, each antibody 30-Sep-08 2
86430 Rheumatoid factor; qualitative 30-Sep-08 2
86431 Rheumatoid factor; quantitative 30-Sep-08 2
86480 Tuberculosis test, cell mediated immunity antigen response measurement; 30-Sep-08 1
gamma interferon
86481 Tuberculosis test, cell mediated immunity antigen response measurement; 15-Oct-12 1
enumeration of gamma interferon-producing T-cells in cell suspension
86485 Skin test; candida 30-Sep-08 1

86486 Skin test; unlisted antigen, each 30-Sep-08
86490 Skin test; coccidioidomycosis 30-Sep-08 1
86510 Skin test; histoplasmosis 30-Sep-08 1
86580 Skin test; tuberculosis, intradermal 30-Sep-08 1
86590 Streptokinase, antibody 30-Sep-08 1
86592 Syphilis test, non-treponemal antibody; qualitative (eg, VDRL, RPR, ART) 30-Sep-08 2
86593 Syphilis test, non-treponemal antibody; quantitative 30-Sep-08 2

86602 Antibody; actinomyces 30-Sep-08 3
86603 Antibody; adenovirus 30-Sep-08 2
86606 Antibody; Aspergillus 30-Sep-08
86609 Antibody; bacterium, not elsewhere specified 30-Sep-08
86611 Antibody; Bartonella 30-Sep-08
86612 Antibody; Blastomyces 30-Sep-08 2
86615 Antibody; Bordetella 30-Sep-08
86617 Antibody; Borrelia burgdorferi (Lyme disease) confirmatory test (eg, Western Blot 30-Sep-08 2
or immunoblot)
86618 Antibody; Borrelia burgdorferi (Lyme disease) 30-Sep-08 2
86619 Antibody; Borrelia (relapsing fever) 30-Sep-08 2
86622 Antibody; Brucella 30-Sep-08
86625 Antibody; Campylobacter 30-Sep-08 2
86628 Antibody; Candida 30-Sep-08 3
86631 Antibody; Chlamydia 30-Sep-08
86632 Antibody; Chlamydia, IgM 30-Sep-08 3
86635 Antibody; Coccidioides 30-Sep-08
86638 Antibody; Coxiella burnetii (Q fever) 30-Sep-08
86641 Antibody; Cryptococcus 30-Sep-08 2
86644 Antibody; cytomegalovirus (CMV) 30-Sep-08
86645 Antibody; cytomegalovirus (CMV), IgM 30-Sep-08 1
86648 Antibody; Diphtheria 30-Sep-08 2
86651 Antibody; encephalitis, California (La Crosse) 30-Sep-08 2
86652 Antibody; encephalitis, Eastern equine 30-Sep-08 2
86653 Antibody; encephalitis, St. Louis 30-Sep-08 2
86654 Antibody; encephalitis, Western equine 30-Sep-08 2
86658 Antibody; enterovirus (eg, coxsackie, echo, polio) 30-Sep-08
86663 Antibody; Epstein-Barr (EB) virus, early antigen (EA) 30-Sep-08 2
86664 Antibody; Epstein-Barr (EB) virus, nuclear antigen (EBNA) 30-Sep-08 2
86665 Antibody; Epstein-Barr (EB) virus, viral capsid (VCA) 30-Sep-08 2
86666 Antibody; Ehrlichia 30-Sep-08
86668 Antibody; Francisella tularensis 30-Sep-08 2
86671 Antibody; fungus, not elsewhere specified 30-Sep-08
86674 Antibody; Giardia lamblia 30-Sep-08 3
86677 Antibody; Helicobacter pylori 30-Sep-08 3
86682 Antibody; helminth, not elsewhere specified 30-Sep-08
86684 Antibody; Haemophilus influenza 30-Sep-08 2
86687 Antibody; HTLV-I 30-Sep-08 2
86688 Antibody; HTLV-II 30-Sep-08 2
86689 Antibody; HTLV or HIV antibody, confirmatory test (eg, Western Blot) 30-Sep-08 2
86692 Antibody; hepatitis, delta agent 30-Sep-08 2
86694 Antibody; herpes simplex, non-specific type test 30-Sep-08 2

86695 Antibody; herpes simplex, type 1 30-Sep-08 2
86696 Antibody; herpes simplex, type 2 30-Sep-08 2
86698 Antibody; histoplasma 30-Sep-08 3
86701 Antibody; HIV-1 30-Sep-08 2
86702 Antibody; HIV-2 30-Sep-08 2
86703 Antibody; HIV-1 and HIV-2, single assay 30-Sep-08 2

86704 Hepatitis B core antibody (HBcAb); total 30-Sep-08 1
86705 Hepatitis B core antibody (HBcAb); IgM antibody 30-Sep-08 1
86706 Hepatitis B surface antibody (HBsAb) 30-Sep-08 2
86707 Hepatitis Be antibody (HBeAb) 30-Sep-08 2
86708 Hepatitis A antibody (HAAb); total 30-Sep-08 1

86709 Hepatitis A antibody (HAAb); IgM antibody 30-Sep-08 1
86710 Antibody; influenza virus 30-Sep-08
86713 Antibody; Legionella 30-Sep-08 3
86717 Antibody; Leishmania 30-Sep-08
86720 Antibody; Leptospira 30-Sep-08 2
86723 Antibody; Listeria monocytogenes 30-Sep-08 2
86727 Antibody; lymphocytic choriomeningitis 30-Sep-08 2
86729 Antibody; lymphogranuloma venereum 30-Sep-08
86732 Antibody; mucormycosis 30-Sep-08 2
86735 Antibody; mumps 30-Sep-08
86738 Antibody; mycoplasma 30-Sep-08 2
86741 Antibody; Neisseria meningitidis 30-Sep-08 2
86744 Antibody; Nocardia 30-Sep-08 2
86747 Antibody; parvovirus 30-Sep-08 2
86750 Antibody; Plasmodium (malaria) 30-Sep-08 4
86753 Antibody; protozoa, not elsewhere specified 30-Sep-08
86756 Antibody; respiratory syncytial virus 30-Sep-08 2
86757 Antibody; Rickettsia 30-Sep-08
86759 Antibody; rotavirus 30-Sep-08 2
86762 Antibody; rubella 30-Sep-08 2
86765 Antibody; rubeola 30-Sep-08
86768 Antibody; Salmonella 30-Sep-08 5
86771 Antibody; Shigella 30-Sep-08 2
86774 Antibody; tetanus 30-Sep-08 2
86777 Antibody; Toxoplasma 30-Sep-08 2
86778 Antibody; Toxoplasma, IgM 30-Sep-08 2
86780 Antibody; Treponema pallidum 15-Oct-12
86781 Antibody; Treponema pallidum, confirmatory test (eg, FTA-abs) 30-Sep-08 14-Oct-12
86784 Antibody; Trichinella 30-Sep-08 2
86787 Antibody; varicella-zoster 30-Sep-08 2
86788 Antibody; West Nile virus, IgM 30-Sep-08 2
86789 Antibody; West Nile virus 30-Sep-08 2
86790 Antibody; virus, not elsewhere specified 30-Sep-08
86793 Antibody; Yersinia 30-Sep-08 2
86800 Thyroglobulin antibody 30-Sep-08 1
86803 Hepatitis C antibody; 30-Sep-08 2
86804 Hepatitis C antibody; confirmatory test (eg, immunoblot) 30-Sep-08 1
86805 Lymphocytotoxicity assay, visual crossmatch; with titration 30-Sep-08

86806 Lymphocytotoxicity assay, visual crossmatch; without titration 30-Sep-08
86807 Serum screening for cytotoxic percent reactive antibody (PRA); standard method 30-Sep-08 2
86808 Serum screening for cytotoxic percent reactive antibody (PRA); quick method 30-Sep-08 1
86812 HLA typing; A, B, or C (eg, A10, B7, B27), single antigen 30-Sep-08 1
86813 HLA typing; A, B, or C, multiple antigens 30-Sep-08 1
86816 HLA typing; DR/DQ, single antigen 30-Sep-08 1
86817 HLA typing; DR/DQ, multiple antigens 30-Sep-08 1
86821 HLA typing; lymphocyte culture, mixed (MLC) 30-Sep-08 3
86822 HLA typing; lymphocyte culture, primed (PLC) 30-Sep-08 3
86825 Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow 15-Oct-12
cytometry); first serum sample or dilution
86826 Human leukocyte antigen (HLA) crossmatch, non-cytotoxic (eg, using flow 15-Oct-12
cytometry); each additional serum sample or sample dilution (List separately in
86849 Unlisted immunology procedure 30-Sep-08
86850 Antibody screen, RBC, each serum technique 30-Sep-08 3
86860 Antibody elution (RBC), each elution 30-Sep-08 2
86870 Antibody identification, RBC antibodies, each panel for each serum technique 30-Sep-08
86880 Antihuman globulin test (Coombs test); direct, each antiserum 30-Sep-08
86885 Antihuman globulin test (Coombs test); indirect, qualitative, each reagent red 30-Sep-08 3
cell
86886 Antihuman globulin test (Coombs test); indirect, each antibody titer 30-Sep-08
86890 Autologous blood or component, collection processing and storage; predeposited 30-Sep-08
86891 Autologous blood or component, collection processing and storage; intra- or 30-Sep-08
postoperative salvage
86900 Blood typing; ABO 30-Sep-08
86901 Blood typing; Rh (D) 30-Sep-08
86902 Blood typing; antigen testing of donor blood using reagent serum, each antigen 15-Oct-12
test
86903 Blood typing; antigen screening for compatible blood unit using reagent serum, 30-Sep-08 14-Oct-12
per unit screened
86904 Blood typing; antigen screening for compatible unit using patient serum, per unit 30-Sep-08
screened
86905 Blood typing; RBC antigens, other than ABO or Rh (D), each 30-Sep-08
86906 Blood typing; Rh phenotyping, complete 30-Sep-08 1
86910 Blood typing, for paternity testing, per individual; ABO, Rh and MN 30-Sep-08
86911 Blood typing, for paternity testing, per individual; each additional antigen system 30-Sep-08
86920 Compatibility test each unit; immediate spin technique 30-Sep-08
86921 Compatibility test each unit; incubation technique 30-Sep-08
86922 Compatibility test each unit; antiglobulin technique 30-Sep-08
86923 Compatibility test each unit; electronic 30-Sep-08
86927 Fresh frozen plasma, thawing, each unit 30-Sep-08
86930 Frozen blood, each unit; freezing (includes preparation) 30-Sep-08 2
86931 Frozen blood, each unit; thawing 30-Sep-08
86932 Frozen blood, each unit; freezing (includes preparation) and thawing 30-Sep-08
86940 Hemolysins and agglutinins; auto, screen, each 30-Sep-08 1
86941 Hemolysins and agglutinins; incubated 30-Sep-08 1
86945 Irradiation of blood product, each unit 30-Sep-08 3
86950 Leukocyte transfusion 30-Sep-08 1
86960 Volume reduction of blood or blood product (eg, red blood cells or platelets), 30-Sep-08 3
each unit
86965 Pooling of platelets or other blood products 30-Sep-08
86970 Pretreatment of RBCs for use in RBC antibody detection, identification, and/or 30-Sep-08
compatibility testing; incubation with chemical agents or drugs, each
compatibility testing; incubation with enzymes, each
compatibility testing; by density gradient separation
86975 Pretreatment of serum for use in RBC antibody identification; incubation with 30-Sep-08 2
drugs, each
86976 Pretreatment of serum for use in RBC antibody identification; by dilution 30-Sep-08 2
86977 Pretreatment of serum for use in RBC antibody identification; incubation with 30-Sep-08 2
inhibitors, each
86978 Pretreatment of serum for use in RBC antibody identification; by differential red 30-Sep-08
cell absorption using patient RBCs or RBCs of known phenotype, each absorption
86985 Splitting of blood or blood products, each unit 30-Sep-08

86999 Unlisted transfusion medicine procedure 30-Sep-08
87001 Animal inoculation, small animal; with observation 30-Sep-08 1

87003 Animal inoculation, small animal; with observation and dissection 30-Sep-08 1
87015 Concentration (any type), for infectious agents 30-Sep-08
87040 Culture, bacterial; blood, aerobic, with isolation and presumptive identification of 30-Sep-08
isolates (includes anaerobic culture, if appropriate)
87045 Culture, bacterial; stool, aerobic, with isolation and preliminary examination (eg, 30-Sep-08 3
KIA, LIA), Salmonella and Shigella species
87046 Culture, bacterial; stool, aerobic, additional pathogens, isolation and 30-Sep-08
presumptive identification of isolates, each plate
87070 Culture, bacterial; any other source except urine, blood or stool, aerobic, with 30-Sep-08
isolation and presumptive identification of isolates
87071 Culture, bacterial; quantitative, aerobic with isolation and presumptive 30-Sep-08
identification of isolates, any source except urine, blood or stool
87073 Culture, bacterial; quantitative, anaerobic with isolation and presumptive 30-Sep-08 3
identification of isolates, any source except urine, blood or stool
87075 Culture, bacterial; any source, except blood, anaerobic with isolation and 30-Sep-08
presumptive identification of isolates
87076 Culture, bacterial; anaerobic isolate, additional methods required for definitive 30-Sep-08
identification, each isolate
87077 Culture, bacterial; aerobic isolate, additional methods required for definitive 30-Sep-08
identification, each isolate
87081 Culture, presumptive, pathogenic organisms, screening only; 30-Sep-08
87084 Culture, presumptive, pathogenic organisms, screening only; with colony 30-Sep-08 2
estimation from density chart
87086 Culture, bacterial; quantitative colony count, urine 30-Sep-08 3
87088 Culture, bacterial; with isolation and presumptive identification of each isolate, 30-Sep-08
urine
87101 Culture, fungi (mold or yeast) isolation, with presumptive identification of 30-Sep-08
isolates; skin, hair, or nail
87102 Culture, fungi (mold or yeast) isolation, with presumptive identification of 30-Sep-08
isolates; other source (except blood)
87103 Culture, fungi (mold or yeast) isolation, with presumptive identification of 30-Sep-08 3
isolates; blood
87106 Culture, fungi, definitive identification, each organism; yeast 30-Sep-08
87107 Culture, fungi, definitive identification, each organism; mold 30-Sep-08
87109 Culture, mycoplasma, any source 30-Sep-08 3
87110 Culture, chlamydia, any source 30-Sep-08 2
87116 Culture, tubercle or other acid-fast bacilli (eg, TB, AFB, mycobacteria) any 30-Sep-08
source, with isolation and presumptive identification of isolates
87118 Culture, mycobacterial, definitive identification, each isolate 30-Sep-08 3
87140 Culture, typing; immunofluorescent method, each antiserum 30-Sep-08
87143 Culture, typing; gas liquid chromatography (GLC) or high pressure liquid 30-Sep-08 2
chromatography (HPLC) method
87147 Culture, typing; immunologic method, other than immunofluoresence (eg, 30-Sep-08
agglutination grouping), per antiserum
87149 Culture, typing; identification by nucleic acid (DNA or RNA) probe, direct probe 30-Sep-08
technique, per culture or isolate, each organism probed
87150 Culture, typing; identification by nucleic acid (DNA or RNA) probe, amplified 15-Oct-12
probe technique, per culture or isolate, each organism probed
87152 Culture, typing; identification by pulse field gel typing 30-Sep-08

87153 Culture, typing; identification by nucleic acid sequencing method, each isolate 15-Oct-12
(eg, sequencing of the 16S rRNA gene)
87158 Culture, typing; other methods 30-Sep-08
87164 Dark field examination, any source (eg, penile, vaginal, oral, skin); includes 30-Sep-08 2
specimen collection
87166 Dark field examination, any source (eg, penile, vaginal, oral, skin); without 30-Sep-08 2
collection
87168 Macroscopic examination; arthropod 30-Sep-08 2
87169 Macroscopic examination; parasite 30-Sep-08 2
87172 Pinworm exam (eg, cellophane tape prep) 30-Sep-08 2
87176 Homogenization, tissue, for culture 30-Sep-08
87177 Ova and parasites, direct smears, concentration and identification 30-Sep-08 3
87181 Susceptibility studies, antimicrobial agent; agar dilution method, per agent (eg, 30-Sep-08
antibiotic gradient strip)
87184 Susceptibility studies, antimicrobial agent; disk method, per plate (12 or fewer 30-Sep-08
agents)
87185 Susceptibility studies, antimicrobial agent; enzyme detection (eg, beta 30-Sep-08
lactamase), per enzyme
87186 Susceptibility studies, antimicrobial agent; microdilution or agar dilution 30-Sep-08
(minimum inhibitory concentration [MIC] or breakpoint), each multi-
antimicrobial, per plate
87187 Susceptibility studies, antimicrobial agent; microdilution or agar dilution, 30-Sep-08
minimum lethal concentration (MLC), each plate (List separately in addition to
87188 Susceptibility studies, antimicrobial agent; macrobroth dilution method, each 30-Sep-08
agent
87190 Susceptibility studies, antimicrobial agent; mycobacteria, proportion method, 30-Sep-08
each agent
87197 Serum bactericidal titer (Schlicter test) 30-Sep-08 1
87205 Smear, primary source with interpretation; Gram or Giemsa stain for bacteria, 30-Sep-08
fungi, or cell types
87206 Smear, primary source with interpretation; fluorescent and/or acid fast stain for 30-Sep-08
bacteria, fungi, parasites, viruses or cell types
87207 Smear, primary source with interpretation; special stain for inclusion bodies or 30-Sep-08 3
parasites (eg, malaria, coccidia, microsporidia, trypanosomes, herpes viruses)
87209 Smear, primary source with interpretation; complex special stain (eg, trichrome, 30-Sep-08
iron hemotoxylin) for ova and parasites
87210 Smear, primary source with interpretation; wet mount for infectious agents (eg, 30-Sep-08
saline, India ink, KOH preps)
87220 Tissue examination by KOH slide of samples from skin, hair, or nails for fungi or 30-Sep-08 3
ectoparasite ova or mites (eg, scabies)
87230 Toxin or antitoxin assay, tissue culture (eg, Clostridium difficile toxin) 30-Sep-08 3
87250 Virus isolation; inoculation of embryonated eggs, or small animal, includes 30-Sep-08 3
observation and dissection
87252 Virus isolation; tissue culture inoculation, observation, and presumptive 30-Sep-08
identification by cytopathic effect
87253 Virus isolation; tissue culture, additional studies or definitive identification (eg, 30-Sep-08
hemabsorption, neutralization, immunofluoresence stain), each isolate
87254 Virus isolation; centrifuge enhanced (shell vial) technique, includes identification 30-Sep-08
with immunofluorescence stain, each virus
87255 Virus isolation; including identification by non-immunologic method, other than 30-Sep-08 2
by cytopathic effect (eg, virus specific enzymatic activity)
87260 Infectious agent antigen detection by immunofluorescent technique; adenovirus 30-Sep-08 2
87265 Infectious agent antigen detection by immunofluorescent technique; Bordetella 30-Sep-08 2

pertussis/parapertussis
87267 Infectious agent antigen detection by immunofluorescent technique; Enterovirus, 30-Sep-08 2
direct fluorescent antibody (DFA)
87269 Infectious agent antigen detection by immunofluorescent technique; giardia 30-Sep-08 3
87270 Infectious agent antigen detection by immunofluorescent technique; Chlamydia 30-Sep-08 2

trachomatis
87271 Infectious agent antigen detection by immunofluorescent technique; 30-Sep-08 2
Cytomegalovirus, direct fluorescent antibody (DFA)
87272 Infectious agent antigen detection by immunofluorescent technique; 30-Sep-08 3
cryptosporidium
87273 Infectious agent antigen detection by immunofluorescent technique; Herpes 30-Sep-08 2
simplex virus type 2
87274 Infectious agent antigen detection by immunofluorescent technique; Herpes 30-Sep-08 2
simplex virus type 1
87275 Infectious agent antigen detection by immunofluorescent technique; influenza B 30-Sep-08 2
virus
87276 Infectious agent antigen detection by immunofluorescent technique; influenza A 30-Sep-08 2
virus
87277 Infectious agent antigen detection by immunofluorescent technique; Legionella 30-Sep-08 2
micdadei
87278 Infectious agent antigen detection by immunofluorescent technique; Legionella 30-Sep-08 3
pneumophila
87279 Infectious agent antigen detection by immunofluorescent technique; 30-Sep-08
Parainfluenza virus, each type
87280 Infectious agent antigen detection by immunofluorescent technique; respiratory 30-Sep-08 2
syncytial virus
87281 Infectious agent antigen detection by immunofluorescent technique; 30-Sep-08
Pneumocystis carinii
87283 Infectious agent antigen detection by immunofluorescent technique; Rubeola 30-Sep-08 2
87285 Infectious agent antigen detection by immunofluorescent technique; Treponema 30-Sep-08 2

pallidum
87290 Infectious agent antigen detection by immunofluorescent technique; Varicella 30-Sep-08 2
zoster virus
87299 Infectious agent antigen detection by immunofluorescent technique; not 30-Sep-08 2
otherwise specified, each organism
87300 Infectious agent antigen detection by immunofluorescent technique, polyvalent 30-Sep-08
for multiple organisms, each polyvalent antiserum
87301 Infectious agent antigen detection by enzyme immunoassay technique, 30-Sep-08 2
qualitative or semiquantitative, multiple-step method; adenovirus enteric types
40/41
qualitative or semiquantitative, multiple-step method; Aspergillus

qualitative or semiquantitative, multiple-step method; Chlamydia trachomatis

qualitative or semiquantitative, multiple-step method; Clostridium difficile
toxin(s)
qualitative or semiquantitative, multiple-step method; Cryptococcus neoformans

qualitative or semiquantitative, multiple-step method; cryptosporidium

qualitative or semiquantitative, multiple-step method; giardia

qualitative or semiquantitative, multiple-step method; cytomegalovirus

qualitative or semiquantitative, multiple-step method; Escherichia coli 0157

qualitative or semiquantitative, multiple-step method; Entamoeba histolytica
dispar group
qualitative or semiquantitative, multiple-step method; Entamoeba histolytica
group
qualitative or semiquantitative, multiple-step method; Helicobacter pylori, stool

qualitative or semiquantitative, multiple-step method; Helicobacter pylori

qualitative or semiquantitative, multiple-step method; hepatitis B surface
antigen (HBsAg)
qualitative or semiquantitative, multiple-step method; hepatitis B surface
antigen (HBsAg) neutralization
qualitative or semiquantitative, multiple-step method; hepatitis Be antigen
(HBeAg)
qualitative or semiquantitative, multiple-step method; hepatitis, delta agent
qualitative or semiquantitative, multiple-step method; Histoplasma capsulatum

qualitative or semiquantitative, multiple-step method; HIV-1

qualitative or semiquantitative, multiple-step method; HIV-2

qualitative or semiquantitative, multiple-step method; Influenza, A or B, each

qualitative or semiquantitative, multiple-step method; respiratory syncytial virus

qualitative or semiquantitative, multiple-step method; rotavirus

qualitative or semiquantitative, multiple-step method; Shiga-like toxin

qualitative or semiquantitative, multiple-step method; Streptococcus, group A
87449 Infectious agent antigen detection by enzyme immunoassay technique 30-Sep-08 3

qualitative or semiquantitative; multiple step method, not otherwise specified,
each organism
qualitative or semiquantitative; single step method, not otherwise specified,
each organism
qualitative or semiquantitative; multiple step method, polyvalent for multiple
organisms, each polyvalent antiserum
87470 Infectious agent detection by nucleic acid (DNA or RNA); Bartonella henselae 30-Sep-08 2
and Bartonella quintana, direct probe technique
and Bartonella quintana, amplified probe technique
and Bartonella quintana, quantification
87475 Infectious agent detection by nucleic acid (DNA or RNA); Borrelia burgdorferi, 30-Sep-08 2
direct probe technique
amplified probe technique
quantification
87480 Infectious agent detection by nucleic acid (DNA or RNA); Candida species, direct 30-Sep-08 2
probe technique
87481 Infectious agent detection by nucleic acid (DNA or RNA); Candida species, 30-Sep-08
87482 Infectious agent detection by nucleic acid (DNA or RNA); Candida species, 30-Sep-08 2
quantification
87485 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia 30-Sep-08 2
pneumoniae, direct probe technique
pneumoniae, amplified probe technique
pneumoniae, quantification
87490 Infectious agent detection by nucleic acid (DNA or RNA); Chlamydia trachomatis, 30-Sep-08 2
quantification
87493 Infectious agent detection by nucleic acid (DNA or RNA); Clostridium difficile, 15-Oct-12
toxin gene(s), amplified probe technique
87495 Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, direct 30-Sep-08 2
probe technique
87496 Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, 30-Sep-08 2
87497 Infectious agent detection by nucleic acid (DNA or RNA); cytomegalovirus, 30-Sep-08 2
quantification
87498 Infectious agent detection by nucleic acid (DNA or RNA); enterovirus, amplified 30-Sep-08 2
probe technique
87500 Infectious agent detection by nucleic acid (DNA or RNA); vancomycin resistance 30-Sep-08 1
(eg, enterococcus species van A, van B), amplified probe technique
87501 Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, reverse 15-Oct-12
transcription and amplified probe technique, each type or subtype
87502 Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for 15-Oct-12 1
multiple types or sub-types, reverse transcription and amplified probe technique,
first 2 types or sub-types
87503 Infectious agent detection by nucleic acid (DNA or RNA); influenza virus, for 15-Oct-12
multiple types or sub-types, multiplex reverse transcription and amplified probe
technique, each additional influenza virus type or sub-type beyond 2 (List
87510 Infectious agent detection by nucleic acid (DNA or RNA); Gardnerella vaginalis, 30-Sep-08 2
quantification
87515 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, direct 30-Sep-08 2
probe technique
87516 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, 30-Sep-08 2
87517 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis B virus, 30-Sep-08 2
quantification
87520 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, direct probe 30-Sep-08 2
technique
87521 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, amplified 30-Sep-08 2
probe technique
87522 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis C, 30-Sep-08 2
quantification
87525 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, direct probe 30-Sep-08 2
technique
87526 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, amplified 30-Sep-08 2
probe technique
87527 Infectious agent detection by nucleic acid (DNA or RNA); hepatitis G, 30-Sep-08 2
quantification
87528 Infectious agent detection by nucleic acid (DNA or RNA); Herpes simplex virus, 30-Sep-08 2
quantification
87531 Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, direct 30-Sep-08 2
probe technique
87532 Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, 30-Sep-08 2
87533 Infectious agent detection by nucleic acid (DNA or RNA); Herpes virus-6, 30-Sep-08 2
quantification
87534 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, direct probe 30-Sep-08 2
technique
87535 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, amplified probe 30-Sep-08 2
technique
87536 Infectious agent detection by nucleic acid (DNA or RNA); HIV-1, quantification 30-Sep-08 2
87537 Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, direct probe 30-Sep-08 2
technique
87538 Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, amplified probe 30-Sep-08 2
technique
87539 Infectious agent detection by nucleic acid (DNA or RNA); HIV-2, quantification 30-Sep-08 2
87540 Infectious agent detection by nucleic acid (DNA or RNA); Legionella 30-Sep-08 2
pneumophila, direct probe technique
pneumophila, amplified probe technique
pneumophila, quantification
87550 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria species, 30-Sep-08 2
quantification
87555 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria 30-Sep-08
tuberculosis, direct probe technique
87556 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria 30-Sep-08
tuberculosis, amplified probe technique
87557 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria 30-Sep-08 2
tuberculosis, quantification
87560 Infectious agent detection by nucleic acid (DNA or RNA); Mycobacteria avium- 30-Sep-08 2
intracellulare, direct probe technique
intracellulare, amplified probe technique
intracellulare, quantification
87580 Infectious agent detection by nucleic acid (DNA or RNA); Mycoplasma 30-Sep-08 2
pneumoniae, direct probe technique
pneumoniae, amplified probe technique
pneumoniae, quantification
87590 Infectious agent detection by nucleic acid (DNA or RNA); Neisseria gonorrhoeae, 30-Sep-08 3
quantification
87620 Infectious agent detection by nucleic acid (DNA or RNA); papillomavirus, human, 30-Sep-08 2
quantification
87640 Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, 30-Sep-08 2
87641 Infectious agent detection by nucleic acid (DNA or RNA); Staphylococcus aureus, 30-Sep-08
methicillin resistant, amplified probe technique
87650 Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group A, 30-Sep-08 1
quantification
87653 Infectious agent detection by nucleic acid (DNA or RNA); Streptococcus, group B, 30-Sep-08 1
87660 Infectious agent detection by nucleic acid (DNA or RNA); Trichomonas vaginalis, 30-Sep-08 1
87797 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; 30-Sep-08 3
direct probe technique, each organism
87798 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; 30-Sep-08
amplified probe technique, each organism
87799 Infectious agent detection by nucleic acid (DNA or RNA), not otherwise specified; 30-Sep-08 3
quantification, each organism
87800 Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; 30-Sep-08 2
direct probe(s) technique
87801 Infectious agent detection by nucleic acid (DNA or RNA), multiple organisms; 30-Sep-08
amplified probe(s) technique
87802 Infectious agent antigen detection by immunoassay with direct optical 30-Sep-08 2
observation; Streptococcus, group B
observation; Clostridium difficile toxin A
observation; Influenza
observation; respiratory syncytial virus
observation; Trichomonas vaginalis
87809 Infectious agent antigen detection by immunoassay with direct optical 30-Sep-08
observation; adenovirus
observation; Chlamydia trachomatis
observation; Neisseria gonorrhoeae
observation; Streptococcus, group A
87899 Infectious agent antigen detection by immunoassay with direct optical 30-Sep-08
observation; not otherwise specified
87900 Infectious agent drug susceptibility phenotype prediction using regularly 30-Sep-08 1
updated genotypic bioinformatics
87901 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, reverse 30-Sep-08 1
transcriptase and protease regions
87902 Infectious agent genotype analysis by nucleic acid (DNA or RNA); Hepatitis C 30-Sep-08 1
virus
87903 Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug 30-Sep-08 1
resistance tissue culture analysis, HIV 1; first through 10 drugs tested
87904 Infectious agent phenotype analysis by nucleic acid (DNA or RNA) with drug 30-Sep-08
resistance tissue culture analysis, HIV 1; each additional drug tested (List
87905 Infectious agent enzymatic activity other than virus (eg, sialidase activity in 15-Oct-12
vaginal fluid)
87906 Infectious agent genotype analysis by nucleic acid (DNA or RNA); HIV-1, other 15-Oct-12 2
region (eg, integrase, fusion)
87999 Unlisted microbiology procedure 30-Sep-08
88000 Necropsy (autopsy), gross examination only; without CNS 30-Sep-08
88005 Necropsy (autopsy), gross examination only; with brain 30-Sep-08
88007 Necropsy (autopsy), gross examination only; with brain and spinal cord 30-Sep-08
88012 Necropsy (autopsy), gross examination only; infant with brain 30-Sep-08
88014 Necropsy (autopsy), gross examination only; stillborn or newborn with brain 30-Sep-08
88016 Necropsy (autopsy), gross examination only; macerated stillborn 30-Sep-08
88020 Necropsy (autopsy), gross and microscopic; without CNS 30-Sep-08
88025 Necropsy (autopsy), gross and microscopic; with brain 30-Sep-08
88027 Necropsy (autopsy), gross and microscopic; with brain and spinal cord 30-Sep-08
88028 Necropsy (autopsy), gross and microscopic; infant with brain 30-Sep-08
88029 Necropsy (autopsy), gross and microscopic; stillborn or newborn with brain 30-Sep-08
88036 Necropsy (autopsy), limited, gross and/or microscopic; regional 30-Sep-08
88037 Necropsy (autopsy), limited, gross and/or microscopic; single organ 30-Sep-08
88040 Necropsy (autopsy); forensic examination 30-Sep-08
88045 Necropsy (autopsy); coroner's call 30-Sep-08

88099 Unlisted necropsy (autopsy) procedure 30-Sep-08
88104 Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears 30-Sep-08 4
with interpretation
88106 Cytopathology, fluids, washings or brushings, except cervical or vaginal; simple 30-Sep-08 3
filter method with interpretation
88107 Cytopathology, fluids, washings or brushings, except cervical or vaginal; smears 30-Sep-08
and simple filter preparation with interpretation
88108 Cytopathology, concentration technique, smears and interpretation (eg, 30-Sep-08
Saccomanno technique)
88112 Cytopathology, selective cellular enhancement technique with interpretation 30-Sep-08
(eg, liquid based slide preparation method), except cervical or vaginal
88120 Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with 15-Oct-12 2
morphometric analysis, 3-5 molecular probes, each specimen; manual
88121 Cytopathology, in situ hybridization (eg, FISH), urinary tract specimen with 15-Oct-12 2
morphometric analysis, 3-5 molecular probes, each specimen; using computer-
assisted technology
88125 Cytopathology, forensic (eg, sperm) 30-Sep-08 1
88130 Sex chromatin identification; Barr bodies 30-Sep-08 1
88140 Sex chromatin identification; peripheral blood smear, polymorphonuclear 30-Sep-08 1
drumsticks
88141 Cytopathology, cervical or vaginal (any reporting system), requiring 30-Sep-08 1
interpretation by physician
88142 Cytopathology, cervical or vaginal (any reporting system), collected in 30-Sep-08 1
preservative fluid, automated thin layer preparation; manual screening under
physician supervision
preservative fluid, automated thin layer preparation; with manual screening and
rescreening under physician supervision
88147 Cytopathology smears, cervical or vaginal; screening by automated system 30-Sep-08 1
under physician supervision
88148 Cytopathology smears, cervical or vaginal; screening by automated system with 30-Sep-08 1
manual rescreening under physician supervision
88150 Cytopathology, slides, cervical or vaginal; manual screening under physician 30-Sep-08 1
supervision
88152 Cytopathology, slides, cervical or vaginal; with manual screening and computer- 30-Sep-08 1
assisted rescreening under physician supervision
88153 Cytopathology, slides, cervical or vaginal; with manual screening and 30-Sep-08 1
rescreening under physician supervision
88154 Cytopathology, slides, cervical or vaginal; with manual screening and computer- 30-Sep-08 1
assisted rescreening using cell selection and review under physician supervision
88155 Cytopathology, slides, cervical or vaginal, definitive hormonal evaluation (eg, 30-Sep-08 1
maturation index, karyopyknotic index, estrogenic index) (List separately in
addition to code[s] for other technical and interpretation services)
88160 Cytopathology, smears, any other source; screening and interpretation 30-Sep-08 4
88161 Cytopathology, smears, any other source; preparation, screening and 30-Sep-08 4
interpretation
88162 Cytopathology, smears, any other source; extended study involving over 5 slides 30-Sep-08 3
and/or multiple stains
88164 Cytopathology, slides, cervical or vaginal (the Bethesda System); manual 30-Sep-08 1
screening under physician supervision
88165 Cytopathology, slides, cervical or vaginal (the Bethesda System); with manual 30-Sep-08 1
screening and rescreening under physician supervision
screening and computer-assisted rescreening under physician supervision
screening and computer-assisted rescreening using cell selection and review
under physician supervision
88172 Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic 30-Sep-08 3
study to determine adequacy for diagnosis, first evaluation episode, each site
88173 Cytopathology, evaluation of fine needle aspirate; interpretation and report 30-Sep-08 3

preservative fluid, automated thin layer preparation; screening by automated
system, under physician supervision
preservative fluid, automated thin layer preparation; with screening by
automated system and manual rescreening or review, under physician
supervision
88177 Cytopathology, evaluation of fine needle aspirate; immediate cytohistologic 15-Oct-12 2
study to determine adequacy for diagnosis, each separate additional evaluation
episode, same site (List separately in addition to code for primary procedure)
88182 Flow cytometry, cell cycle or DNA analysis 30-Sep-08 2

88184 Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical 30-Sep-08 1
component only; first marker
88185 Flow cytometry, cell surface, cytoplasmic, or nuclear marker, technical 30-Sep-08
component only; each additional marker (List separately in addition to code for
first marker)
88187 Flow cytometry, interpretation; 2 to 8 markers 30-Sep-08 1
88188 Flow cytometry, interpretation; 9 to 15 markers 30-Sep-08 1
88189 Flow cytometry, interpretation; 16 or more markers 30-Sep-08 1
88199 Unlisted cytopathology procedure 30-Sep-08
88230 Tissue culture for non-neoplastic disorders; lymphocyte 30-Sep-08 2

88233 Tissue culture for non-neoplastic disorders; skin or other solid tissue biopsy 30-Sep-08 3
88235 Tissue culture for non-neoplastic disorders; amniotic fluid or chorionic villus cells 30-Sep-08
88237 Tissue culture for neoplastic disorders; bone marrow, blood cells 30-Sep-08
88239 Tissue culture for neoplastic disorders; solid tumor 30-Sep-08 3
88240 Cryopreservation, freezing and storage of cells, each cell line 30-Sep-08 3
88241 Thawing and expansion of frozen cells, each aliquot 30-Sep-08 3
88245 Chromosome analysis for breakage syndromes; baseline Sister Chromatid 30-Sep-08 1
Exchange (SCE), 20-25 cells
88248 Chromosome analysis for breakage syndromes; baseline breakage, score 50-100 30-Sep-08 1
cells, count 20 cells, 2 karyotypes (eg, for ataxia telangiectasia, Fanconi anemia,
fragile X)
88249 Chromosome analysis for breakage syndromes; score 100 cells, clastogen stress 30-Sep-08 1
(eg, diepoxybutane, mitomycin C, ionizing radiation, UV radiation)
88261 Chromosome analysis; count 5 cells, 1 karyotype, with banding 30-Sep-08 2

88262 Chromosome analysis; count 15-20 cells, 2 karyotypes, with banding 30-Sep-08 2
88263 Chromosome analysis; count 45 cells for mosaicism, 2 karyotypes, with banding 30-Sep-08 1
88264 Chromosome analysis; analyze 20-25 cells 30-Sep-08 2

88267 Chromosome analysis, amniotic fluid or chorionic villus, count 15 cells, 1 30-Sep-08 2
karyotype, with banding
88269 Chromosome analysis, in situ for amniotic fluid cells, count cells from 6-12 30-Sep-08 2
colonies, 1 karyotype, with banding
88271 Molecular cytogenetics; DNA probe, each (eg, FISH) 30-Sep-08
88272 Molecular cytogenetics; chromosomal in situ hybridization, analyze 3-5 cells (eg, 30-Sep-08
for derivatives and markers)
88273 Molecular cytogenetics; chromosomal in situ hybridization, analyze 10-30 cells 30-Sep-08 3
(eg, for microdeletions)
88274 Molecular cytogenetics; interphase in situ hybridization, analyze 25-99 cells 30-Sep-08
88275 Molecular cytogenetics; interphase in situ hybridization, analyze 100-300 cells 30-Sep-08
88280 Chromosome analysis; additional karyotypes, each study 30-Sep-08

88283 Chromosome analysis; additional specialized banding technique (eg, NOR, C- 30-Sep-08 2
banding)
88285 Chromosome analysis; additional cells counted, each study 30-Sep-08
88289 Chromosome analysis; additional high resolution study 30-Sep-08 1
88291 Cytogenetics and molecular cytogenetics, interpretation and report 30-Sep-08 1
88299 Unlisted cytogenetic study 30-Sep-08
88300 Level I - Surgical pathology, gross examination only 30-Sep-08 2

88302 Level II - Surgical pathology, gross and microscopic examination Appendix, 30-Sep-08 2
incidental, Fallopian tube, sterilization, Fingers/toes, amputation, traumatic,
Foreskin, newborn, Hernia sac, any location, Hydrocele sac, Nerve, Skin, plastic
repair, Sympathetic ganglion, Testis, castration, Vaginal mucosa, incidental, Vas
deferens, sterilization
88304 Level III - Surgical pathology, gross and microscopic examination Abortion, 30-Sep-08
induced, Abscess, Aneurysm - arterial/ventricular, Anus, tag, Appendix, other
than incidental, Artery, atheromatous plaque, Bartholin's gland cyst, Bone
fragment(s), other than pathologic fracture, Bursa/synovial cyst, Carpal tunnel
tissue, Cartilage, shavings, Cholesteatoma, Colon, colostomy stoma, Conjunctiva
- biopsy/pterygium, Cornea, Diverticulum - esophagus/small intestine,
Dupuytren's contracture tissue, Femoral head, other than fracture,
Fissure/fistula, Foreskin, other than newborn, Gallbladder, Ganglion cyst,
Hematoma, Hemorrhoids, Hydatid of Morgagni, Intervertebral disc, Joint, loose
body, Meniscus, Mucocele, salivary, Neuroma - Morton's/traumatic, Pilonidal
cyst/sinus, Polyps, inflammatory - nasal/sinusoidal, Skin - cyst/tag/debridement,
Soft tissue, debridement, Soft tissue, lipoma, Spermatocele, Tendon/tendon
sheath, Testicular appendage, Thrombus or embolus, Tonsil and/or adenoids,
Varicocele, Vas deferens, other than sterilization, Vein, varicosity
88305 Level IV - Surgical pathology, gross and microscopic examination Abortion - 30-Sep-08
spontaneous/missed, Artery, biopsy, Bone marrow, biopsy, Bone exostosis,
Brain/meninges, other than for tumor resection, Breast, biopsy, not requiring
microscopic evaluation of surgical margins, Breast, reduction mammoplasty,
Bronchus, biopsy, Cell block, any source, Cervix, biopsy, Colon, biopsy,
Duodenum, biopsy, Endocervix, curettings/biopsy, Endometrium,
curettings/biopsy, Esophagus, biopsy, Extremity, amputation, traumatic,
Fallopian tube, biopsy, Fallopian tube, ectopic pregnancy, Femoral head, fracture,
Fingers/toes, amputation, non-traumatic, Gingiva/oral mucosa, biopsy, Heart
valve, Joint, resection, Kidney, biopsy, Larynx, biopsy, Leiomyoma(s), uterine
myomectomy - without uterus, Lip, biopsy/wedge resection, Lung, transbronchial
biopsy, Lymph node, biopsy, Muscle, biopsy, Nasal mucosa, biopsy,
Nasopharynx/oropharynx, biopsy, Nerve, biopsy, Odontogenic/dental cyst,
Omentum, biopsy, Ovary with or without tube, non-neoplastic, Ovary,
biopsy/wedge resection, Parathyroid gland, Peritoneum, biopsy, Pituitary tumor,
Placenta, other than third trimester, Pleura/pericardium - biopsy/tissue, Polyp,
cervical/endometrial, Polyp, colorectal, Polyp, stomach/small intestine, Prostate,
needle biopsy, Prostate, TUR, Salivary gland, biopsy, Sinus, paranasal biopsy,
Skin, other than cyst/tag/debridement/plastic repair, Small intestine, biopsy, Soft
tissue, other than tumor/mass/lipoma/debridement, Spleen, Stomach, biopsy,
Synovium, Testis, other than tumor/biopsy/castration, Thyroglossal duct/brachial
cleft cyst, Tongue, biopsy, Tonsil, biopsy, Trachea, biopsy, Ureter, biopsy,
Urethra, biopsy, Urinary bladder, biopsy, Uterus, with or without tubes and
ovaries, for prolapse, Vagina, biopsy, Vulva/labia, biopsy
88307 Level V - Surgical pathology, gross and microscopic examination Adrenal, 30-Sep-08
resection, Bone - biopsy/curettings, Bone fragment(s), pathologic fracture, Brain,
biopsy, Brain/meninges, tumor resection, Breast, excision of lesion, requiring
microscopic evaluation of surgical margins, Breast, mastectomy - partial/simple,
Cervix, conization, Colon, segmental resection, other than for tumor, Extremity,
amputation, non-traumatic, Eye, enucleation, Kidney, partial/total nephrectomy,
Larynx, partial/total resection, Liver, biopsy - needle/wedge, Liver, partial
resection, Lung, wedge biopsy, Lymph nodes, regional resection, Mediastinum,
mass, Myocardium, biopsy, Odontogenic tumor, Ovary with or without tube,
neoplastic, Pancreas, biopsy, Placenta, third trimester, Prostate, except radical
resection, Salivary gland, Sentinel lymph node, Small intestine, resection, other
than for tumor, Soft tissue mass (except lipoma) - biopsy/simple excision,
Stomach - subtotal/total resection, other than for tumor, Testis, biopsy, Thymus,
tumor, Thyroid, total/lobe, Ureter, resection, Urinary bladder, TUR, Uterus, with
or without tubes and ovaries, other than neoplastic/prolapse
88309 Level VI - Surgical pathology, gross and microscopic examination Bone resection, 30-Sep-08 3
Breast, mastectomy - with regional lymph nodes, Colon, segmental resection for
tumor, Colon, total resection, Esophagus, partial/total resection, Extremity,
disarticulation, Fetus, with dissection, Larynx, partial/total resection - with
regional lymph nodes, Lung - total/lobe/segment resection, Pancreas,
total/subtotal resection, Prostate, radical resection, Small intestine, resection for
tumor, Soft tissue tumor, extensive resection, Stomach - subtotal/total resection
for tumor, Testis, tumor, Tongue/tonsil -resection for tumor, Urinary bladder,
partial/total resection, Uterus, with or without tubes and ovaries, neoplastic,
Vulva, total/subtotal resection
88311 Decalcification procedure (List separately in addition to code for surgical 30-Sep-08 4
pathology examination)
88312 Special stains; Group I for microorganisms (eg, Gridley, acid fast, methenamine 30-Sep-08
silver), including interpretation and report, each
88313 Special stains; Group II, all other (eg, iron, trichrome), except 30-Sep-08
immunocytochemistry and immunoperoxidase stains, including interpretation
and report, each
88314 Special stains; histochemical staining with frozen section(s), including 30-Sep-08
interpretation and report (List separately in addition to code for primary
procedure)
88318 Determinative histochemistry to identify chemical components (eg, copper, zinc) 30-Sep-08 3
88319 Determinative histochemistry or cytochemistry to identify enzyme constituents, 30-Sep-08

each
88321 Consultation and report on referred slides prepared elsewhere 30-Sep-08 1
88323 Consultation and report on referred material requiring preparation of slides 30-Sep-08 1
88325 Consultation, comprehensive, with review of records and specimens, with report 30-Sep-08 1
on referred material
88329 Pathology consultation during surgery; 30-Sep-08 4
88331 Pathology consultation during surgery; first tissue block, with frozen section(s), 30-Sep-08 11
single specimen
88332 Pathology consultation during surgery; each additional tissue block with frozen 30-Sep-08
section(s) (List separately in addition to code for primary procedure)
88333 Pathology consultation during surgery; cytologic examination (eg, touch prep, 30-Sep-08 4
squash prep), initial site
88334 Pathology consultation during surgery; cytologic examination (eg, touch prep, 30-Sep-08
squash prep), each additional site (List separately in addition to code for primary
procedure)
88342 Immunohistochemistry (including tissue immunoperoxidase), each antibody 30-Sep-08
88346 Immunofluorescent study, each antibody; direct method 30-Sep-08

88347 Immunofluorescent study, each antibody; indirect method 30-Sep-08 4
88348 Electron microscopy; diagnostic 30-Sep-08 1
88349 Electron microscopy; scanning 30-Sep-08 1
88355 Morphometric analysis; skeletal muscle 30-Sep-08 1
88356 Morphometric analysis; nerve 30-Sep-08 1
88358 Morphometric analysis; tumor (eg, DNA ploidy) 30-Sep-08 2
88360 Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen 30-Sep-08
receptor/progesterone receptor), quantitative or semiquantitative, each
antibody; manual
88361 Morphometric analysis, tumor immunohistochemistry (eg, Her-2/neu, estrogen 30-Sep-08
receptor/progesterone receptor), quantitative or semiquantitative, each
antibody; using computer-assisted technology
88362 Nerve teasing preparations 30-Sep-08 1
88363 Examination and selection of retrieved archival (ie, previously diagnosed) 15-Oct-12 1
tissue(s) for molecular analysis (eg, KRAS mutational analysis)
88365 In situ hybridization (eg, FISH), each probe 30-Sep-08

88367 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) 30-Sep-08
each probe; using computer-assisted technology
88368 Morphometric analysis, in situ hybridization (quantitative or semi-quantitative) 30-Sep-08
each probe; manual
88371 Protein analysis of tissue by Western Blot, with interpretation and report; 30-Sep-08 1
88372 Protein analysis of tissue by Western Blot, with interpretation and report; 30-Sep-08 1
immunological probe for band identification, each
88380 Microdissection (ie, sample preparation of microscopically identified target); 30-Sep-08 1
laser capture
88381 Microdissection (ie, sample preparation of microscopically identified target); 30-Sep-08 1
manual
88384 Array-based evaluation of multiple molecular probes; 11 through 50 probes 30-Sep-08 1
88387 Macroscopic examination, dissection, and preparation of tissue for non- 15-Oct-12
microscopic analytical studies (eg, nucleic acid-based molecular studies); each
tissue preparation (eg, a single lymph node)
88388 Macroscopic examination, dissection, and preparation of tissue for non- 15-Oct-12
microscopic analytical studies (eg, nucleic acid-based molecular studies); in
conjunction with a touch imprint, intraoperative consultation, or frozen section,
each tissue preparation (eg, a single lymph node) (List separately in addition to
88399 Unlisted surgical pathology procedure 30-Sep-08
88400 Bilirubin, total, transcutaneous 30-Sep-08 14-Oct-12

88720 Bilirubin, total, transcutaneous 15-Oct-12 1
88738 Hemoglobin (Hgb), quantitative, transcutaneous 15-Oct-12
88740 Hemoglobin, quantitative, transcutaneous, per day; carboxyhemoglobin 15-Oct-12 1
88741 Hemoglobin, quantitative, transcutaneous, per day; methemoglobin 15-Oct-12 1

88749 Unlisted in vivo (eg, transcutaneous) laboratory service 15-Oct-12
89049 Caffeine halothane contracture test (CHCT) for malignant hyperthermia 30-Sep-08 1
susceptibility, including interpretation and report
89050 Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except 30-Sep-08 2
blood;
89051 Cell count, miscellaneous body fluids (eg, cerebrospinal fluid, joint fluid), except 30-Sep-08 2
blood; with differential count
89055 Leukocyte assessment, fecal, qualitative or semiquantitative 30-Sep-08 2
89060 Crystal identification by light microscopy with or without polarizing lens analysis, 30-Sep-08 2
tissue or any body fluid (except urine)
89100 Duodenal intubation and aspiration; single specimen (eg, simple bile study or 30-Sep-08 14-Oct-12
afferent loop culture) plus appropriate test procedure
89105 Duodenal intubation and aspiration; collection of multiple fractional specimens 30-Sep-08 14-Oct-12
with pancreatic or gallbladder stimulation, single or double lumen tube
89125 Fat stain, feces, urine, or respiratory secretions 30-Sep-08 2

89130 Gastric intubation and aspiration, diagnostic, each specimen, for chemical 30-Sep-08 14-Oct-12
analyses or cytopathology;
89132 Gastric intubation and aspiration, diagnostic, each specimen, for chemical 30-Sep-08 14-Oct-12
analyses or cytopathology; after stimulation
89135 Gastric intubation, aspiration, and fractional collections (eg, gastric secretory 30-Sep-08 14-Oct-12
study); one hour
study); 2 hours
study); 2 hours including gastric stimulation (eg, histalog, pentagastrin)
study); 3 hours, including gastric stimulation
89160 Meat fibers, feces 30-Sep-08 1
89190 Nasal smear for eosinophils 30-Sep-08 1
89220 Sputum, obtaining specimen, aerosol induced technique (separate procedure) 30-Sep-08 1
89225 Starch granules, feces 30-Sep-08 14-Oct-12

89230 Sweat collection by iontophoresis 30-Sep-08 1
89235 Water load test 30-Sep-08 14-Oct-12
89240 Unlisted miscellaneous pathology test 30-Sep-08
89250 Culture of oocyte(s)/embryo(s), less than 4 days; 30-Sep-08 1
89251 Culture of oocyte(s)/embryo(s), less than 4 days; with co-culture of 30-Sep-08 1

oocyte(s)/embryos
89253 Assisted embryo hatching, microtechniques (any method) 30-Sep-08 1
89254 Oocyte identification from follicular fluid 30-Sep-08 1
89255 Preparation of embryo for transfer (any method) 30-Sep-08 1
89257 Sperm identification from aspiration (other than seminal fluid) 30-Sep-08 1
89258 Cryopreservation; embryo(s) 30-Sep-08 1
89259 Cryopreservation; sperm 30-Sep-08 1
89260 Sperm isolation; simple prep (eg, sperm wash and swim-up) for insemination or 30-Sep-08 1
diagnosis with semen analysis
89261 Sperm isolation; complex prep (eg, Percoll gradient, albumin gradient) for 30-Sep-08 1
insemination or diagnosis with semen analysis
89264 Sperm identification from testis tissue, fresh or cryopreserved 30-Sep-08 1
89268 Insemination of oocytes 30-Sep-08 1
89272 Extended culture of oocyte(s)/embryo(s), 4-7 days 30-Sep-08 1
89280 Assisted oocyte fertilization, microtechnique; less than or equal to 10 oocytes 30-Sep-08 1
89281 Assisted oocyte fertilization, microtechnique; greater than 10 oocytes 30-Sep-08 1
89290 Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre- 30-Sep-08 1
implantation genetic diagnosis); less than or equal to 5 embryos
89291 Biopsy, oocyte polar body or embryo blastomere, microtechnique (for pre- 30-Sep-08 1
implantation genetic diagnosis); greater than 5 embryos
89300 Semen analysis; presence and/or motility of sperm including Huhner test (post 30-Sep-08 1
coital)
89310 Semen analysis; motility and count (not including Huhner test) 30-Sep-08 1
89320 Semen analysis; volume, count, motility, and differential 30-Sep-08 1
89321 Semen analysis; sperm presence and motility of sperm, if performed 30-Sep-08 1
89322 Semen analysis; volume, count, motility, and differential using strict morphologic 30-Sep-08 1
criteria (eg, Kruger)
89325 Sperm antibodies 30-Sep-08 1
89329 Sperm evaluation; hamster penetration test 30-Sep-08 1

89330 Sperm evaluation; cervical mucus penetration test, with or without spinnbarkeit 30-Sep-08 1
test
89331 Sperm evaluation, for retrograde ejaculation, urine (sperm concentration, 30-Sep-08 1
motility, and morphology, as indicated)
89335 Cryopreservation, reproductive tissue, testicular 30-Sep-08 1
89342 Storage (per year); embryo(s) 30-Sep-08 1
89343 Storage (per year); sperm/semen 30-Sep-08 1
89344 Storage (per year); reproductive tissue, testicular/ovarian 30-Sep-08 1
89346 Storage (per year); oocyte(s) 30-Sep-08 1
89352 Thawing of cryopreserved; embryo(s) 30-Sep-08 1
89353 Thawing of cryopreserved; sperm/semen, each aliquot 30-Sep-08 1
89354 Thawing of cryopreserved; reproductive tissue, testicular/ovarian 30-Sep-08 1
89356 Thawing of cryopreserved; oocytes, each aliquot 30-Sep-08 2

89398 Unlisted reproductive medicine laboratory procedure 15-Oct-12
90281 Immune globulin (Ig), human, for intramuscular use 30-Sep-08
90283 Immune globulin (IgIV), human, for intravenous use 30-Sep-08
90284 Immune globulin (SCIg), human, for use in subcutaneous infusions, 100 mg, each 30-Sep-08
90287 Botulinum antitoxin, equine, any route 30-Sep-08
90288 Botulism immune globulin, human, for intravenous use 30-Sep-08
90291 Cytomegalovirus immune globulin (CMV-IgIV), human, for intravenous use 30-Sep-08
90296 Diphtheria antitoxin, equine, any route 30-Sep-08
90371 Hepatitis B immune globulin (HBIg), human, for intramuscular use 30-Sep-08
90375 Rabies immune globulin (RIg), human, for intramuscular and/or subcutaneous 30-Sep-08
use
90376 Rabies immune globulin, heat-treated (RIg-HT), human, for intramuscular and/or 30-Sep-08
subcutaneous use
90378 Respiratory syncytial virus, monoclonal antibody, recombinant, for intramuscular 30-Sep-08
use, 50 mg, each
90379 Respiratory syncytial virus immune globulin (RSV-IgIV), human, for intravenous 30-Sep-08 14-Oct-12
use
90384 Rho(D) immune globulin (RhIg), human, full-dose, for intramuscular use 30-Sep-08
90385 Rho(D) immune globulin (RhIg), human, mini-dose, for intramuscular use 30-Sep-08
90386 Rho(D) immune globulin (RhIgIV), human, for intravenous use 30-Sep-08
90389 Tetanus immune globulin (TIg), human, for intramuscular use 30-Sep-08
90393 Vaccinia immune globulin, human, for intramuscular use 30-Sep-08
90396 Varicella-zoster immune globulin, human, for intramuscular use 30-Sep-08
90399 Unlisted immune globulin 30-Sep-08
90460 Immunization administration through 18 years of age via any route of 15-Oct-12
administration, with counseling by physician or other qualified health care
professional; first vaccine/toxoid component
90461 Immunization administration through 18 years of age via any route of 15-Oct-12
administration, with counseling by physician or other qualified health care
professional; each additional vaccine/toxoid component (List separately in
90465 Immunization administration younger than 8 years of age (includes 30-Sep-08 14-Oct-12
percutaneous, intradermal, subcutaneous, or intramuscular injections) when the
physician counsels the patient/family; first injection (single or combination
vaccine/toxoid), per day
90466 Immunization administration younger than 8 years of age (includes 30-Sep-08 14-Oct-12
percutaneous, intradermal, subcutaneous, or intramuscular injections) when the
physician counsels the patient/family; each additional injection (single or
combination vaccine/toxoid), per d
90467 Immunization administration younger than age 8 years (includes intranasal or 30-Sep-08 14-Oct-12
oral routes of administration) when the physician counsels the patient/family;
first administration (single or combination vaccine/toxoid), per day
90468 Immunization administration younger than age 8 years (includes intranasal or 30-Sep-08 14-Oct-12
oral routes of administration) when the physician counsels the patient/family;
each additional administration (single or combination vaccine/toxoid), per day
(List separately in
90470 H1N1 immunization administration (intramuscular, intranasal), including 15-Oct-12
counseling when performed
90471 Immunization administration (includes percutaneous, intradermal, 30-Sep-08 1
subcutaneous, or intramuscular injections); 1 vaccine (single or combination
vaccine/toxoid)
90472 Immunization administration (includes percutaneous, intradermal, 30-Sep-08 4
subcutaneous, or intramuscular injections); each additional vaccine (single or
combination vaccine/toxoid) (List separately in addition to code for primary
procedure)
90473 Immunization administration by intranasal or oral route; 1 vaccine (single or 30-Sep-08 1
combination vaccine/toxoid)
90474 Immunization administration by intranasal or oral route; each additional vaccine 30-Sep-08 1
(single or combination vaccine/toxoid) (List separately in addition to code for
primary procedure)
90760 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 30-Sep-08 14-Oct-12
90761 Intravenous infusion, hydration; each additional hour (List separately in addition 30-Sep-08 14-Oct-12
90765 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or 30-Sep-08 14-Oct-12
drug); initial, up to 1 hour
drug); each additional hour (List separately in addition to code for primary
procedure)
drug); additional sequential infusion, up to 1 hour (List separately in addition to
drug); concurrent infusion (List separately in addition to code for primary
procedure)
90769 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); 30-Sep-08 14-Oct-12
initial, up to one hour, including pump set-up and establishment of
subcutaneous infusion site(s)
each additional hour (List separately in addition to code for primary procedure)
additional pump set-up with establishment of new subcutaneous infusion site(s)
90772 Therapeutic, prophylactic or diagnostic injection (specify substance or drug); 30-Sep-08 14-Oct-12
subcutaneous or intramuscular
intra-arterial
intravenous push, single or initial substance/drug
each additional sequential intravenous push of a new substance/drug (List
each additional sequential intravenous push of the same substance/drug
provided in a facility (List separately in addition to code for primary procedure)
90779 Unlisted therapeutic, prophylactic or diagnostic intravenous or intra-arterial 30-Sep-08 14-Oct-12

injection or infusion
90801 Psychiatric diagnostic interview examination 30-Sep-08 1
90802 Interactive psychiatric diagnostic interview examination using play equipment, 30-Sep-08 1
physical devices, language interpreter, or other mechanisms of communication
90804 Individual psychotherapy, insight oriented, behavior modifying and/or 30-Sep-08 1

supportive, in an office or outpatient facility, approximately 20 to 30 minutes
face-to-face with the patient;
face-to-face with the patient; with medical evaluation and management services

90810 Individual psychotherapy, interactive, using play equipment, physical devices, 30-Sep-08 1
language interpreter, or other mechanisms of non-verbal communication, in an
office or outpatient facility, approximately 20 to 30 minutes face-to-face with the
patient;
patient; with medical evaluation and management services
patient;
patient;

supportive, in an inpatient hospital, partial hospital or residential care setting,
approximately 20 to 30 minutes face-to-face with the patient;

approximately 20 to 30 minutes face-to-face with the patient; with medical
evaluation and management services


inpatient hospital, partial hospital or residential care setting, approximately 20 to
30 minutes face-to-face with the patient;
30 minutes face-to-face with the patient; with medical evaluation and
management services
management services
management services
90845 Psychoanalysis 30-Sep-08 1
90846 Family psychotherapy (without the patient present) 30-Sep-08 1
90847 Family psychotherapy (conjoint psychotherapy) (with patient present) 30-Sep-08 1
90849 Multiple-family group psychotherapy 30-Sep-08 1
90853 Group psychotherapy (other than of a multiple-family group) 30-Sep-08 1
90857 Interactive group psychotherapy 30-Sep-08 1
90862 Pharmacologic management, including prescription, use, and review of 30-Sep-08 1

medication with no more than minimal medical psychotherapy
90865 Narcosynthesis for psychiatric diagnostic and therapeutic purposes (eg, sodium 30-Sep-08 1
amobarbital (Amytal) interview)
90867 Therapeutic repetitive transcranial magnetic stimulation treatment; planning 15-Oct-12 1
90868 Therapeutic repetitive transcranial magnetic stimulation treatment; delivery and 15-Oct-12 1
management, per session
90870 Electroconvulsive therapy (includes necessary monitoring) 30-Sep-08 1
90875 Individual psychophysiological therapy incorporating biofeedback training by any 30-Sep-08

modality (face-to-face with the patient), with psychotherapy (eg, insight
oriented, behavior modifying or supportive psychotherapy); approximately 20-30
minutes
90876 Individual psychophysiological therapy incorporating biofeedback training by any 30-Sep-08
modality (face-to-face with the patient), with psychotherapy (eg, insight
oriented, behavior modifying or supportive psychotherapy); approximately 45-50
minutes
90880 Hypnotherapy 30-Sep-08 1
90882 Environmental intervention for medical management purposes on a psychiatric 30-Sep-08

patient's behalf with agencies, employers, or institutions
90885 Psychiatric evaluation of hospital records, other psychiatric reports, 30-Sep-08
psychometric and/or projective tests, and other accumulated data for medical
diagnostic purposes
90887 Interpretation or explanation of results of psychiatric, other medical 30-Sep-08
examinations and procedures, or other accumulated data to family or other
responsible persons, or advising them how to assist patient
90889 Preparation of report of patient's psychiatric status, history, treatment, or 30-Sep-08
progress (other than for legal or consultative purposes) for other physicians,
agencies, or insurance carriers
90899 Unlisted psychiatric service or procedure 30-Sep-08
90901 Biofeedback training by any modality 30-Sep-08 1

90911 Biofeedback training, perineal muscles, anorectal or urethral sphincter, including 30-Sep-08 1
EMG and/or manometry
90918 End-stage renal disease (ESRD) related services per full month; for patients 30-Sep-08 14-Oct-12
younger than two years of age to include monitoring for the adequacy of
nutrition, assessment of growth and development, and counseling of parents
between two and eleven years of age to include monitoring for the adequacy of
between twelve and nineteen years of age to include monitoring for the
adequacy of nutrition, assessment of growth and development, and counseling
of parents
twenty years of age and older
90922 End-stage renal disease (ESRD) related services (less than full month), per day; 30-Sep-08 14-Oct-12
for patients younger than two years of age
for patients between two and eleven years of age
for patients between twelve and nineteen years of age
for patients twenty years of age and older
90935 Hemodialysis procedure with single physician evaluation 30-Sep-08 1
90937 Hemodialysis procedure requiring repeated evaluation(s) with or without 30-Sep-08 1

substantial revision of dialysis prescription
90940 Hemodialysis access flow study to determine blood flow in grafts and 30-Sep-08 2
arteriovenous fistulae by an indicator method
90945 Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, 30-Sep-08 1
hemofiltration, or other continuous renal replacement therapies), with single
physician evaluation
90947 Dialysis procedure other than hemodialysis (eg, peritoneal dialysis, 30-Sep-08 1
hemofiltration, or other continuous renal replacement therapies) requiring
repeated physician evaluations, with or without substantial revision of dialysis
prescription
90951 End-stage renal disease (ESRD) related services monthly, for patients younger 15-Oct-12 1
than 2 years of age to include monitoring for the adequacy of nutrition,
assessment of growth and development, and counseling of parents; with 4 or
more face-to-face physician visits per month
assessment of growth and development, and counseling of parents; with 2-3
face-to-face physician visits per month
assessment of growth and development, and counseling of parents; with 1 face-
to-face physician visit per month
90954 End-stage renal disease (ESRD) related services monthly, for patients 2-11 years 15-Oct-12 1
of age to include monitoring for the adequacy of nutrition, assessment of growth
and development, and counseling of parents; with 4 or more face-to-face
physician visits per month
and development, and counseling of parents; with 2-3 face-to-face physician
visits per month
and development, and counseling of parents; with 1 face-to-face physician visit
per month
90957 End-stage renal disease (ESRD) related services monthly, for patients 12-19 15-Oct-12 1
years of age to include monitoring for the adequacy of nutrition, assessment of
growth and development, and counseling of parents; with 4 or more face-to-face
growth and development, and counseling of parents; with 2-3 face-to-face
growth and development, and counseling of parents; with 1 face-to-face
physician visit per month
90960 End-stage renal disease (ESRD) related services monthly, for patients 20 years 15-Oct-12 1
of age and older; with 4 or more face-to-face physician visits per month
of age and older; with 2-3 face-to-face physician visits per month
of age and older; with 1 face-to-face physician visit per month
90963 End-stage renal disease (ESRD) related services for home dialysis per full month, 15-Oct-12 1
for patients younger than 2 years of age to include monitoring for the adequacy
of nutrition, assessment of growth and development, and counseling of parents
for patients 2-11 years of age to include monitoring for the adequacy of
for patients 12-19 years of age to include monitoring for the adequacy of
for patients 20 years of age and older
90967 End-stage renal disease (ESRD) related services for dialysis less than a full 15-Oct-12 1
month of service, per day; for patients younger than 2 years of age
month of service, per day; for patients 2-11 years of age
month of service, per day; for patients 12-19 years of age
month of service, per day; for patients 20 years of age and older
90989 Dialysis training, patient, including helper where applicable, any mode, 30-Sep-08 1
completed course
90993 Dialysis training, patient, including helper where applicable, any mode, course 30-Sep-08 1
not completed, per training session
90997 Hemoperfusion (eg, with activated charcoal or resin) 30-Sep-08 1
90999 Unlisted dialysis procedure, inpatient or outpatient 30-Sep-08
91000 Esophageal intubation and collection of washings for cytology, including 30-Sep-08 14-Oct-12
preparation of specimens (separate procedure)
91010 Esophageal motility (manometric study of the esophagus and/or 30-Sep-08 1
gastroesophageal junction) study with interpretation and report; 2-dimensional
data
91011 Esophageal motility (manometric study of the esophagus and/or 30-Sep-08 14-Oct-12
gastroesophageal junction) study; with mecholyl or similar stimulant
91012 Esophageal motility (manometric study of the esophagus and/or 30-Sep-08 14-Oct-12
gastroesophageal junction) study; with acid perfusion studies
91013 Esophageal motility (manometric study of the esophagus and/or 15-Oct-12 1
gastroesophageal junction) study with interpretation and report; with stimulation
or perfusion during 2-dimensional data study (eg, stimulant, acid or alkali
perfusion) (List separately in addition to code for primary procedure)
91020 Gastric motility (manometric) studies 30-Sep-08 1

91022 Duodenal motility (manometric) study 30-Sep-08 1
91030 Esophagus, acid perfusion (Bernstein) test for esophagitis 30-Sep-08 1
91034 Esophagus, gastroesophageal reflux test; with nasal catheter pH electrode(s) 30-Sep-08 1
placement, recording, analysis and interpretation
91035 Esophagus, gastroesophageal reflux test; with mucosal attached telemetry pH 30-Sep-08 1
electrode placement, recording, analysis and interpretation
91037 Esophageal function test, gastroesophageal reflux test with nasal catheter 30-Sep-08 1
intraluminal impedance electrode(s) placement, recording, analysis and
interpretation;
91038 Esophageal function test, gastroesophageal reflux test with nasal catheter 30-Sep-08 1
intraluminal impedance electrode(s) placement, recording, analysis and
interpretation; prolonged (greater than 1 hour, up to 24 hours)
91040 Esophageal balloon distension provocation study 30-Sep-08 1

91052 Gastric analysis test with injection of stimulant of gastric secretion (eg, 30-Sep-08 14-Oct-12
histamine, insulin, pentagastrin, calcium and secretin)
91055 Gastric intubation, washings, and preparing slides for cytology (separate 30-Sep-08 14-Oct-12
procedure)
91065 Breath hydrogen test (eg, for detection of lactase deficiency, fructose 30-Sep-08 1
intolerance, bacterial overgrowth, or oro-cecal gastrointestinal transit)
91100 Intestinal bleeding tube, passage, positioning and monitoring 30-Sep-08 14-Oct-12
91105 Gastric intubation, and aspiration or lavage for treatment (eg, for ingested 30-Sep-08 14-Oct-12
poisons)
91110 Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus 30-Sep-08 1
through ileum, with physician interpretation and report
91111 Gastrointestinal tract imaging, intraluminal (eg, capsule endoscopy), esophagus 30-Sep-08 1
with physician interpretation and report
91117 Colon motility (manometric) study, minimum 6 hours continuous recording 15-Oct-12 1
(including provocation tests, eg, meal, intracolonic balloon distension,
pharmacologic agents, if performed), with interpretation and report
91120 Rectal sensation, tone, and compliance test (ie, response to graded balloon 30-Sep-08 1
distention)
91122 Anorectal manometry 30-Sep-08 1
91123 Pulsed irrigation of fecal impaction 30-Sep-08 14-Oct-12
91132 Electrogastrography, diagnostic, transcutaneous; 30-Sep-08 1
91133 Electrogastrography, diagnostic, transcutaneous; with provocative testing 30-Sep-08 1
91299 Unlisted diagnostic gastroenterology procedure 30-Sep-08
92002 Ophthalmological services: medical examination and evaluation with initiation of 30-Sep-08 1
diagnostic and treatment program; intermediate, new patient
92004 Ophthalmological services: medical examination and evaluation with initiation of 30-Sep-08 1
diagnostic and treatment program; comprehensive, new patient, 1 or more visits
92012 Ophthalmological services: medical examination and evaluation, with initiation 30-Sep-08 1
or continuation of diagnostic and treatment program; intermediate, established
patient
92014 Ophthalmological services: medical examination and evaluation, with initiation 30-Sep-08 1
or continuation of diagnostic and treatment program; comprehensive,
established patient, 1 or more visits
92015 Determination of refractive state 30-Sep-08
92018 Ophthalmological examination and evaluation, under general anesthesia, with or 30-Sep-08 1
without manipulation of globe for passive range of motion or other manipulation
to facilitate diagnostic examination; complete
92019 Ophthalmological examination and evaluation, under general anesthesia, with or 30-Sep-08 1
without manipulation of globe for passive range of motion or other manipulation
to facilitate diagnostic examination; limited
92020 Gonioscopy (separate procedure) 30-Sep-08 1

92025 Computerized corneal topography, unilateral or bilateral, with interpretation and 30-Sep-08 1
report
92060 Sensorimotor examination with multiple measurements of ocular deviation (eg, 30-Sep-08 1
restrictive or paretic muscle with diplopia) with interpretation and report
92065 Orthoptic and/or pleoptic training, with continuing medical direction and 30-Sep-08 1
evaluation
92070 Fitting of contact lens for treatment of disease, including supply of lens 30-Sep-08 2
92081 Visual field examination, unilateral or bilateral, with interpretation and report; 30-Sep-08 1
limited examination (eg, tangent screen, Autoplot, arc perimeter, or single
stimulus level automated test, such as Octopus 3 or 7 equivalent)
intermediate examination (eg, at least 2 isopters on Goldmann perimeter, or
semiquantitative, automated suprathreshold screening program, Humphrey
suprathreshold automatic diagnostic test, Octopus program 33)
extended examination (eg, Goldmann visual fields with at least 3 isopters
plotted and static determination within the central 30 degrees, or quantitative,
automated threshold perimetry, Octopus program G-1, 32 or 42, Humphrey
visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2)
92100 Serial tonometry (separate procedure) with multiple measurements of 30-Sep-08 1

intraocular pressure over an extended time period with interpretation and
report, same day (eg, diurnal curve or medical treatment of acute elevation of
intraocular pressure)
92120 Tonography with interpretation and report, recording indentation tonometer 30-Sep-08 1
method or perilimbal suction method
92130 Tonography with water provocation 30-Sep-08 1
92132 Scanning computerized ophthalmic diagnostic imaging, anterior segment, with 15-Oct-12 1
interpretation and report, unilateral or bilateral
92133 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with 15-Oct-12 1
interpretation and report, unilateral or bilateral; optic nerve
92134 Scanning computerized ophthalmic diagnostic imaging, posterior segment, with 15-Oct-12 1
interpretation and report, unilateral or bilateral; retina
92135 Scanning computerized ophthalmic diagnostic imaging, posterior segment, (eg, 30-Sep-08 14-Oct-12
scanning laser) with interpretation and report, unilateral
92136 Ophthalmic biometry by partial coherence interferometry with intraocular lens 30-Sep-08
power calculation
92140 Provocative tests for glaucoma, with interpretation and report, without 30-Sep-08 1
tonography
92225 Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, 30-Sep-08 2
melanoma), with interpretation and report; initial
92226 Ophthalmoscopy, extended, with retinal drawing (eg, for retinal detachment, 30-Sep-08 2
melanoma), with interpretation and report; subsequent
92227 Remote imaging for detection of retinal disease (eg, retinopathy in a patient with 15-Oct-12 1
diabetes) with analysis and report under physician supervision, unilateral or
bilateral
92228 Remote imaging for monitoring and management of active retinal disease (eg, 15-Oct-12 1
diabetic retinopathy) with physician review, interpretation and report, unilateral
or bilateral
92230 Fluorescein angioscopy with interpretation and report 30-Sep-08 2
92235 Fluorescein angiography (includes multiframe imaging) with interpretation and 30-Sep-08 2
report
92240 Indocyanine-green angiography (includes multiframe imaging) with 30-Sep-08 2
92250 Fundus photography with interpretation and report 30-Sep-08 1
92260 Ophthalmodynamometry 30-Sep-08 1
92265 Needle oculoelectromyography, 1 or more extraocular muscles, 1 or both eyes, 30-Sep-08 1
92270 Electro-oculography with interpretation and report 30-Sep-08 1
92275 Electroretinography with interpretation and report 30-Sep-08 1
92283 Color vision examination, extended, eg, anomaloscope or equivalent 30-Sep-08 1
92284 Dark adaptation examination with interpretation and report 30-Sep-08 1
92285 External ocular photography with interpretation and report for documentation of 30-Sep-08 1
medical progress (eg, close-up photography, slit lamp photography,
goniophotography, stereo-photography)
92286 Special anterior segment photography with interpretation and report; with 30-Sep-08 1
specular endothelial microscopy and cell count
92287 Special anterior segment photography with interpretation and report; with 30-Sep-08 1
fluorescein angiography
92310 Prescription of optical and physical characteristics of and fitting of contact lens, 30-Sep-08
with medical supervision of adaptation; corneal lens, both eyes, except for
aphakia
92311 Prescription of optical and physical characteristics of and fitting of contact lens, 30-Sep-08 1
with medical supervision of adaptation; corneal lens for aphakia, 1 eye
with medical supervision of adaptation; corneal lens for aphakia, both eyes
with medical supervision of adaptation; corneoscleral lens
92314 Prescription of optical and physical characteristics of contact lens, with medical 30-Sep-08
supervision of adaptation and direction of fitting by independent technician;
corneal lens, both eyes except for aphakia
92315 Prescription of optical and physical characteristics of contact lens, with medical 30-Sep-08 1
corneal lens for aphakia, 1 eye
corneal lens for aphakia, both eyes
corneoscleral lens
92325 Modification of contact lens (separate procedure), with medical supervision of 30-Sep-08 1
adaptation
92326 Replacement of contact lens 30-Sep-08 2
92340 Fitting of spectacles, except for aphakia; monofocal 30-Sep-08
92341 Fitting of spectacles, except for aphakia; bifocal 30-Sep-08
92342 Fitting of spectacles, except for aphakia; multifocal, other than bifocal 30-Sep-08
92352 Fitting of spectacle prosthesis for aphakia; monofocal 30-Sep-08
92353 Fitting of spectacle prosthesis for aphakia; multifocal 30-Sep-08
92354 Fitting of spectacle mounted low vision aid; single element system 30-Sep-08
92355 Fitting of spectacle mounted low vision aid; telescopic or other compound lens 30-Sep-08
system
92358 Prosthesis service for aphakia, temporary (disposable or loan, including 30-Sep-08
materials)
92370 Repair and refitting spectacles; except for aphakia 30-Sep-08
92371 Repair and refitting spectacles; spectacle prosthesis for aphakia 30-Sep-08
92499 Unlisted ophthalmological service or procedure 30-Sep-08
92502 Otolaryngologic examination under general anesthesia 30-Sep-08 1

92504 Binocular microscopy (separate diagnostic procedure) 30-Sep-08 1
92506 Evaluation of speech, language, voice, communication, and/or auditory 30-Sep-08
processing
92507 Treatment of speech, language, voice, communication, and/or auditory 30-Sep-08 1
processing disorder; individual
92508 Treatment of speech, language, voice, communication, and/or auditory 30-Sep-08 1
processing disorder; group, 2 or more individuals
92511 Nasopharyngoscopy with endoscope (separate procedure) 30-Sep-08 1
92512 Nasal function studies (eg, rhinomanometry) 30-Sep-08 1
92516 Facial nerve function studies (eg, electroneuronography) 30-Sep-08 1
92520 Laryngeal function studies (ie, aerodynamic testing and acoustic testing) 30-Sep-08 1
92526 Treatment of swallowing dysfunction and/or oral function for feeding 30-Sep-08 1
92531 Spontaneous nystagmus, including gaze 30-Sep-08
92532 Positional nystagmus test 30-Sep-08
92533 Caloric vestibular test, each irrigation (binaural, bithermal stimulation 30-Sep-08
constitutes 4 tests)
92534 Optokinetic nystagmus test 30-Sep-08
92540 Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric 15-Oct-12
gaze fixation nystagmus, with recording, positional nystagmus test, minimum of
4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and
peripheral stimulation, with recording, and oscillating tracking test, with
recording
92541 Spontaneous nystagmus test, including gaze and fixation nystagmus, with 30-Sep-08 1
recording
92542 Positional nystagmus test, minimum of 4 positions, with recording 30-Sep-08 1
92543 Caloric vestibular test, each irrigation (binaural, bithermal stimulation 30-Sep-08 4
constitutes 4 tests), with recording
92544 Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with 30-Sep-08 1
recording
92545 Oscillating tracking test, with recording 30-Sep-08 1
92546 Sinusoidal vertical axis rotational testing 30-Sep-08 1
92547 Use of vertical electrodes (List separately in addition to code for primary 30-Sep-08
procedure)
92548 Computerized dynamic posturography 30-Sep-08 1
92550 Tympanometry and reflex threshold measurements 15-Oct-12
92551 Screening test, pure tone, air only 30-Sep-08
92552 Pure tone audiometry (threshold); air only 30-Sep-08 1
92553 Pure tone audiometry (threshold); air and bone 30-Sep-08 1
92555 Speech audiometry threshold; 30-Sep-08 1
92556 Speech audiometry threshold; with speech recognition 30-Sep-08 1
92557 Comprehensive audiometry threshold evaluation and speech recognition (92553 30-Sep-08 1
and 92556 combined)
92559 Audiometric testing of groups 30-Sep-08
92560 Bekesy audiometry; screening 30-Sep-08
92561 Bekesy audiometry; diagnostic 30-Sep-08 1

92562 Loudness balance test, alternate binaural or monaural 30-Sep-08 1
92563 Tone decay test 30-Sep-08 1
92564 Short increment sensitivity index (SISI) 30-Sep-08 1
92565 Stenger test, pure tone 30-Sep-08 1
92567 Tympanometry (impedance testing) 30-Sep-08 1
92568 Acoustic reflex testing, threshold 30-Sep-08 1
92569 Acoustic reflex testing; decay 30-Sep-08 14-Oct-12
92570 Acoustic immittance testing, includes tympanometry (impedance testing), 15-Oct-12
acoustic reflex threshold testing, and acoustic reflex decay testing
92571 Filtered speech test 30-Sep-08 1

92572 Staggered spondaic word test 30-Sep-08 1
92575 Sensorineural acuity level test 30-Sep-08 1
92576 Synthetic sentence identification test 30-Sep-08 1
92577 Stenger test, speech 30-Sep-08 1
92579 Visual reinforcement audiometry (VRA) 30-Sep-08 1
92582 Conditioning play audiometry 30-Sep-08 1
92583 Select picture audiometry 30-Sep-08 1
92584 Electrocochleography 30-Sep-08 1
92585 Auditory evoked potentials for evoked response audiometry and/or testing of the 30-Sep-08 1
central nervous system; comprehensive
92586 Auditory evoked potentials for evoked response audiometry and/or testing of the 30-Sep-08 1
central nervous system; limited
92587 Evoked otoacoustic emissions; limited (single stimulus level, either transient or 30-Sep-08 1
distortion products)
92588 Evoked otoacoustic emissions; comprehensive or diagnostic evaluation 30-Sep-08 1
(comparison of transient and/or distortion product otoacoustic emissions at
multiple levels and frequencies)
92590 Hearing aid examination and selection; monaural 30-Sep-08
92591 Hearing aid examination and selection; binaural 30-Sep-08
92592 Hearing aid check; monaural 30-Sep-08
92593 Hearing aid check; binaural 30-Sep-08
92594 Electroacoustic evaluation for hearing aid; monaural 30-Sep-08
92595 Electroacoustic evaluation for hearing aid; binaural 30-Sep-08
92596 Ear protector attenuation measurements 30-Sep-08 1
92597 Evaluation for use and/or fitting of voice prosthetic device to supplement oral 30-Sep-08
speech
92601 Diagnostic analysis of cochlear implant, patient younger than 7 years of age; 30-Sep-08 1
with programming
92602 Diagnostic analysis of cochlear implant, patient younger than 7 years of age; 30-Sep-08 1
subsequent reprogramming
92603 Diagnostic analysis of cochlear implant, age 7 years or older; with programming 30-Sep-08 1
92604 Diagnostic analysis of cochlear implant, age 7 years or older; subsequent 30-Sep-08 1
reprogramming
92605 Evaluation for prescription of non-speech-generating augmentative and 30-Sep-08
alternative communication device
92606 Therapeutic service(s) for the use of non-speech-generating device, including 30-Sep-08
programming and modification
92607 Evaluation for prescription for speech-generating augmentative and alternative 30-Sep-08
communication device, face-to-face with the patient; first hour
92608 Evaluation for prescription for speech-generating augmentative and alternative 30-Sep-08
communication device, face-to-face with the patient; each additional 30 minutes
92609 Therapeutic services for the use of speech-generating device, including 30-Sep-08 1
programming and modification
92610 Evaluation of oral and pharyngeal swallowing function 30-Sep-08 1
92611 Motion fluoroscopic evaluation of swallowing function by cine or video recording 30-Sep-08
92612 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video 30-Sep-08

recording;
92613 Flexible fiberoptic endoscopic evaluation of swallowing by cine or video 30-Sep-08 1
recording; physician interpretation and report only
92614 Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or 30-Sep-08
video recording;
92615 Flexible fiberoptic endoscopic evaluation, laryngeal sensory testing by cine or 30-Sep-08 1
video recording; physician interpretation and report only
92616 Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory 30-Sep-08
testing by cine or video recording;
92617 Flexible fiberoptic endoscopic evaluation of swallowing and laryngeal sensory 30-Sep-08 1
testing by cine or video recording; physician interpretation and report only
92620 Evaluation of central auditory function, with report; initial 60 minutes 30-Sep-08 1
92621 Evaluation of central auditory function, with report; each additional 15 minutes 30-Sep-08
92625 Assessment of tinnitus (includes pitch, loudness matching, and masking) 30-Sep-08 1
92626 Evaluation of auditory rehabilitation status; first hour 30-Sep-08 1

92627 Evaluation of auditory rehabilitation status; each additional 15 minutes (List 30-Sep-08
92630 Auditory rehabilitation; prelingual hearing loss 30-Sep-08
92633 Auditory rehabilitation; postlingual hearing loss 30-Sep-08
92640 Diagnostic analysis with programming of auditory brainstem implant, per hour 30-Sep-08
92700 Unlisted otorhinolaryngological service or procedure 30-Sep-08
92950 Cardiopulmonary resuscitation (eg, in cardiac arrest) 30-Sep-08 3

92953 Temporary transcutaneous pacing 30-Sep-08 2
92960 Cardioversion, elective, electrical conversion of arrhythmia; external 30-Sep-08 2
92961 Cardioversion, elective, electrical conversion of arrhythmia; internal (separate 30-Sep-08 1
procedure)
92970 Cardioassist-method of circulatory assist; internal 30-Sep-08 1
92971 Cardioassist-method of circulatory assist; external 30-Sep-08 1
92973 Percutaneous transluminal coronary thrombectomy (List separately in addition to 30-Sep-08 2
92974 Transcatheter placement of radiation delivery device for subsequent coronary 30-Sep-08 1
intravascular brachytherapy (List separately in addition to code for primary
procedure)
92975 Thrombolysis, coronary; by intracoronary infusion, including selective coronary 30-Sep-08 1
angiography
92977 Thrombolysis, coronary; by intravenous infusion 30-Sep-08 1
92978 Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation 30-Sep-08 1
and/or therapeutic intervention including imaging supervision, interpretation and
report; initial vessel (List separately in addition to code for primary procedure)
92979 Intravascular ultrasound (coronary vessel or graft) during diagnostic evaluation 30-Sep-08 2
and/or therapeutic intervention including imaging supervision, interpretation and
report; each additional vessel (List separately in addition to code for primary
procedure)
92980 Transcatheter placement of an intracoronary stent(s), percutaneous, with or 30-Sep-08 1
without other therapeutic intervention, any method; single vessel
92981 Transcatheter placement of an intracoronary stent(s), percutaneous, with or 30-Sep-08 2

without other therapeutic intervention, any method; each additional vessel (List
92982 Percutaneous transluminal coronary balloon angioplasty; single vessel 30-Sep-08 1
92984 Percutaneous transluminal coronary balloon angioplasty; each additional vessel 30-Sep-08 2
92986 Percutaneous balloon valvuloplasty; aortic valve 30-Sep-08 1

92987 Percutaneous balloon valvuloplasty; mitral valve 30-Sep-08 1
92990 Percutaneous balloon valvuloplasty; pulmonary valve 30-Sep-08 1
92992 Atrial septectomy or septostomy; transvenous method, balloon (eg, Rashkind 30-Sep-08 1
type) (includes cardiac catheterization)
92993 Atrial septectomy or septostomy; blade method (Park septostomy) (includes 30-Sep-08 1
cardiac catheterization)
92995 Percutaneous transluminal coronary atherectomy, by mechanical or other 30-Sep-08 1
method, with or without balloon angioplasty; single vessel
92996 Percutaneous transluminal coronary atherectomy, by mechanical or other 30-Sep-08 2
method, with or without balloon angioplasty; each additional vessel (List
92997 Percutaneous transluminal pulmonary artery balloon angioplasty; single vessel 30-Sep-08 1
92998 Percutaneous transluminal pulmonary artery balloon angioplasty; each 30-Sep-08 2

additional vessel (List separately in addition to code for primary procedure)
93000 Electrocardiogram, routine ECG with at least 12 leads; with interpretation and 30-Sep-08 3
report
93005 Electrocardiogram, routine ECG with at least 12 leads; tracing only, without 30-Sep-08 3
93010 Electrocardiogram, routine ECG with at least 12 leads; interpretation and report 30-Sep-08
only
93012 Telephonic transmission of post-symptom electrocardiogram rhythm strip(s), 24- 30-Sep-08 14-Oct-12
hour attended monitoring, per 30 day period of time; tracing only
93014 Telephonic transmission of post-symptom electrocardiogram rhythm strip(s), 24- 30-Sep-08 14-Oct-12
hour attended monitoring, per 30 day period of time; physician review with
interpretation and report only
93015 Cardiovascular stress test using maximal or submaximal treadmill or bicycle 30-Sep-08 2
exercise, continuous electrocardiographic monitoring, and/or pharmacological
stress; with physician supervision, with interpretation and report
stress; physician supervision only, without interpretation and report
stress; tracing only, without interpretation and report
stress; interpretation and report only
93024 Ergonovine provocation test 30-Sep-08 1
93025 Microvolt T-wave alternans for assessment of ventricular arrhythmias 30-Sep-08 1
93040 Rhythm ECG, 1-3 leads; with interpretation and report 30-Sep-08 3
93041 Rhythm ECG, 1-3 leads; tracing only without interpretation and report 30-Sep-08 2
93042 Rhythm ECG, 1-3 leads; interpretation and report only 30-Sep-08 3
93224 External electrocardiographic recording up to 48 hours by continuous rhythm 30-Sep-08 1
recording and storage; includes recording, scanning analysis with report,
physician review and interpretation
recording and storage; recording (includes connection, recording, and
disconnection)
recording and storage; scanning analysis with report
recording and storage; physician review and interpretation
93228 External mobile cardiovascular telemetry with electrocardiographic recording, 15-Oct-12 1
concurrent computerized real time data analysis and greater than 24 hours of
accessible ECG data storage (retrievable with query) with ECG triggered and
patient selected events transmitted to a remote attended surveillance center for
up to 30 days; physician review and interpretation with report
93229 External mobile cardiovascular telemetry with electrocardiographic recording, 15-Oct-12 1

concurrent computerized real time data analysis and greater than 24 hours of
accessible ECG data storage (retrievable with query) with ECG triggered and
patient selected events transmitted to a remote attended surveillance center for
up to 30 days; technical support for connection and patient instructions for use,
attended surveillance, analysis and physician prescribed transmission of daily
and emergent data reports
93230 Electrocardiographic monitoring for 24 hours by continuous original ECG 30-Sep-08 14-Oct-12
waveform recording and storage without superimposition scanning utilizing a
device capable of producing a full miniaturized printout; includes recording,
microprocessor-based analysis
device capable of producing a full miniaturized printout; recording (includes
hook-up, recording, and disco
device capable of producing a full miniaturized printout; microprocessor-based
analysis with report
device capable of producing a full miniaturized printout; physician review and
interpretation
93235 Electrocardiographic monitoring for 24 hours by continuous computerized 30-Sep-08 14-Oct-12
monitoring and non-continuous recording, and real-time data analysis utilizing a
device capable of producing intermittent full-sized waveform tracings, possibly
patient activated; inc
patient activated; mon
patient activated; phy
93268 External patient and, when performed, auto activated electrocardiographic 30-Sep-08 1
rhythm derived event recording with symptom-related memory loop with remote
download capability up to 30 days, 24-hour attended monitoring; includes
transmission, physician review and interpretation
download capability up to 30 days, 24-hour attended monitoring; recording
(includes connection, recording, and disconnection)
download capability up to 30 days, 24-hour attended monitoring; transmission
download and analysis
download capability up to 30 days, 24-hour attended monitoring; physician
review and interpretation
93278 Signal-averaged electrocardiography (SAECG), with or without ECG 30-Sep-08 1
93279 Programming device evaluation (in person) with iterative adjustment of the 15-Oct-12 1
implantable device to test the function of the device and select optimal
permanent programmed values with physician analysis, review and report;
single lead pacemaker system
permanent programmed values with physician analysis, review and report; dual
lead pacemaker system
multiple lead pacemaker system
single lead implantable cardioverter-defibrillator system
permanent programmed values with physician analysis, review and report; dual
lead implantable cardioverter-defibrillator system
multiple lead implantable cardioverter-defibrillator system
implantable loop recorder system
93286 Peri-procedural device evaluation (in person) and programming of device system 15-Oct-12 2
parameters before or after a surgery, procedure, or test with physician analysis,
review and report; single, dual, or multiple lead pacemaker system
93287 Peri-procedural device evaluation (in person) and programming of device system 15-Oct-12 2
parameters before or after a surgery, procedure, or test with physician analysis,
review and report; single, dual, or multiple lead implantable cardioverter-
defibrillator system
93288 Interrogation device evaluation (in person) with physician analysis, review and 15-Oct-12 1
report, includes connection, recording and disconnection per patient encounter;
single, dual, or multiple lead pacemaker system
single, dual, or multiple lead implantable cardioverter-defibrillator system,
including analysis of heart rhythm derived data elements
implantable cardiovascular monitor system, including analysis of 1 or more
recorded physiologic cardiovascular data elements from all internal and external
sensors
implantable loop recorder system, including heart rhythm derived data analysis
wearable defibrillator system
93293 Transtelephonic rhythm strip pacemaker evaluation(s) single, dual, or multiple 15-Oct-12 1
lead pacemaker system, includes recording with and without magnet application
with physician analysis, review and report(s), up to 90 days
93294 Interrogation device evaluation(s) (remote), up to 90 days; single, dual, or 15-Oct-12 1

multiple lead pacemaker system with interim physician analysis, review(s) and
report(s)
multiple lead implantable cardioverter-defibrillator system with interim physician
analysis, review(s) and report(s)
multiple lead pacemaker system or implantable cardioverter-defibrillator system,
remote data acquisition(s), receipt of transmissions and technician review,
technical support and distribution of results
93297 Interrogation device evaluation(s), (remote) up to 30 days; implantable 15-Oct-12 1

cardiovascular monitor system, including analysis of 1 or more recorded
physiologic cardiovascular data elements from all internal and external sensors,
physician analysis, review(s) and report(s)
93298 Interrogation device evaluation(s), (remote) up to 30 days; implantable loop 15-Oct-12 1

recorder system, including analysis of recorded heart rhythm data, physician
analysis, review(s) and report(s)
93299 Interrogation device evaluation(s), (remote) up to 30 days; implantable 15-Oct-12 1
cardiovascular monitor system or implantable loop recorder system, remote data
acquisition(s), receipt of transmissions and technician review, technical support
and distribution of results
93303 Transthoracic echocardiography for congenital cardiac anomalies; complete 30-Sep-08 1
93304 Transthoracic echocardiography for congenital cardiac anomalies; follow-up or 30-Sep-08 1

limited study
93306 Echocardiography, transthoracic, real-time with image documentation (2D), 15-Oct-12 1
includes M-mode recording, when performed, complete, with spectral Doppler
echocardiography, and with color flow Doppler echocardiography
93307 Echocardiography, transthoracic, real-time with image documentation (2D), 30-Sep-08 1

includes M-mode recording, when performed, complete, without spectral or color
Doppler echocardiography
includes M-mode recording, when performed, follow-up or limited study
93312 Echocardiography, transesophageal, real-time with image documentation (2D) 30-Sep-08 2

(with or without M-mode recording); including probe placement, image
acquisition, interpretation and report
(with or without M-mode recording); placement of transesophageal probe only

(with or without M-mode recording); image acquisition, interpretation and report
only
93315 Transesophageal echocardiography for congenital cardiac anomalies; including 30-Sep-08 2
probe placement, image acquisition, interpretation and report
93316 Transesophageal echocardiography for congenital cardiac anomalies; placement 30-Sep-08 2

of transesophageal probe only
93317 Transesophageal echocardiography for congenital cardiac anomalies; image 30-Sep-08 2
acquisition, interpretation and report only
93318 Echocardiography, transesophageal (TEE) for monitoring purposes, including 30-Sep-08 2
probe placement, real time 2-dimensional image acquisition and interpretation
leading to ongoing (continuous) assessment of (dynamically changing) cardiac
pumping function and to therapeutic measures on an immediate time basis
93320 Doppler echocardiography, pulsed wave and/or continuous wave with spectral 30-Sep-08 1
display (List separately in addition to codes for echocardiographic imaging);
complete
93321 Doppler echocardiography, pulsed wave and/or continuous wave with spectral 30-Sep-08 1
display (List separately in addition to codes for echocardiographic imaging);
follow-up or limited study (List separately in addition to codes for
echocardiographic imaging)
93325 Doppler echocardiography color flow velocity mapping (List separately in 30-Sep-08 1
addition to codes for echocardiography)
includes M-mode recording, when performed, during rest and cardiovascular
stress test using treadmill, bicycle exercise and/or pharmacologically induced
stress, with interpretation and report;
93351 Echocardiography, transthoracic, real-time with image documentation (2D), 15-Oct-12 1
includes M-mode recording, when performed, during rest and cardiovascular
stress test using treadmill, bicycle exercise and/or pharmacologically induced
stress, with interpretation and report; including performance of continuous
electrocardiographic monitoring, with physician supervision
93352 Use of echocardiographic contrast agent during stress echocardiography (List 15-Oct-12 1
93451 Right heart catheterization including measurement(s) of oxygen saturation and 15-Oct-12 1
cardiac output, when performed
93452 Left heart catheterization including intraprocedural injection(s) for left 15-Oct-12 1
ventriculography, imaging supervision and interpretation, when performed
93453 Combined right and left heart catheterization including intraprocedural 15-Oct-12 1
injection(s) for left ventriculography, imaging supervision and interpretation,
when performed
93454 Catheter placement in coronary artery(s) for coronary angiography, including 15-Oct-12 1
intraprocedural injection(s) for coronary angiography, imaging supervision and
interpretation;
interpretation; with catheter placement(s) in bypass graft(s) (internal mammary,
free arterial venous grafts) including intraprocedural injection(s) for bypass graft
angiography
interpretation; with right heart catheterization
interpretation; with catheter placement(s) in bypass graft(s) (internal mammary,
free arterial, venous grafts) including intraprocedural injection(s) for bypass graft
angiography and right heart catheterization
interpretation; with left heart catheterization including intraprocedural
injection(s) for left ventriculography, when performed
interpretation; with left heart catheterization including intraprocedural
injection(s) for left ventriculography, when performed, catheter placement(s) in
bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass
graft angiography
interpretation; with right and left heart catheterization including intraprocedural
injection(s) for left ventriculography, when performed
interpretation; with right and left heart catheterization including intraprocedural
injection(s) for left ventriculography, when performed, catheter placement(s) in
bypass graft(s) (internal mammary, free arterial, venous grafts) with bypass
graft angiography
93462 Left heart catheterization by transseptal puncture through intact septum or by 15-Oct-12 1
transapical puncture (List separately in addition to code for primary procedure)
93463 Pharmacologic agent administration (eg, inhaled nitric oxide, intravenous 15-Oct-12 1
infusion of nitroprusside, dobutamine, milrinone, or other agent) including
assessing hemodynamic measurements before, during, after and repeat
pharmacologic agent administration, when performed (List separately in addition
93464 Physiologic exercise study (eg, bicycle or arm ergometry) including assessing 15-Oct-12 1
hemodynamic measurements before and after (List separately in addition to
93501 Right heart catheterization 30-Sep-08 14-Oct-12
93503 Insertion and placement of flow directed catheter (eg, Swan-Ganz) for 30-Sep-08 2
monitoring purposes
93505 Endomyocardial biopsy 30-Sep-08 1
93508 Catheter placement in coronary artery(s), arterial coronary conduit(s), and/or 30-Sep-08 14-Oct-12
venous coronary bypass graft(s) for coronary angiography without concomitant
left heart catheterization
93510 Left heart catheterization, retrograde, from the brachial artery, axillary artery or 30-Sep-08 14-Oct-12
femoral artery; percutaneous
93511 Left heart catheterization, retrograde, from the brachial artery, axillary artery or 30-Sep-08 14-Oct-12
femoral artery; by cutdown
93514 Left heart catheterization by left ventricular puncture 30-Sep-08 14-Oct-12
93524 Combined transseptal and retrograde left heart catheterization 30-Sep-08 14-Oct-12
93526 Combined right heart catheterization and retrograde left heart catheterization 30-Sep-08 14-Oct-12
93527 Combined right heart catheterization and transseptal left heart catheterization 30-Sep-08 14-Oct-12
through intact septum (with or without retrograde left heart catheterization)
93528 Combined right heart catheterization with left ventricular puncture (with or 30-Sep-08 14-Oct-12
without retrograde left heart catheterization)
93529 Combined right heart catheterization and left heart catheterization through 30-Sep-08 14-Oct-12
existing septal opening (with or without retrograde left heart catheterization)
93530 Right heart catheterization, for congenital cardiac anomalies 30-Sep-08 1

93531 Combined right heart catheterization and retrograde left heart catheterization, 30-Sep-08 1
for congenital cardiac anomalies
93532 Combined right heart catheterization and transseptal left heart catheterization 30-Sep-08 1
through intact septum with or without retrograde left heart catheterization, for
congenital cardiac anomalies
93533 Combined right heart catheterization and transseptal left heart catheterization 30-Sep-08 1
through existing septal opening, with or without retrograde left heart
catheterization, for congenital cardiac anomalies
93539 Injection procedure during cardiac catheterization; for selective opacification of 30-Sep-08 14-Oct-12
arterial conduits (eg, internal mammary), whether native or used for bypass
93540 Injection procedure during cardiac catheterization; for selective opacification of 30-Sep-08 14-Oct-12
aortocoronary venous bypass grafts, one or more coronary arteries
93541 Injection procedure during cardiac catheterization; for pulmonary angiography 30-Sep-08 14-Oct-12
93542 Injection procedure during cardiac catheterization; for selective right ventricular 30-Sep-08 14-Oct-12
or right atrial angiography
93543 Injection procedure during cardiac catheterization; for selective left ventricular 30-Sep-08 14-Oct-12
or left atrial angiography
93544 Injection procedure during cardiac catheterization; for aortography 30-Sep-08 14-Oct-12
93545 Injection procedure during cardiac catheterization; for selective coronary 30-Sep-08 14-Oct-12
angiography (injection of radiopaque material may be by hand)
93555 Imaging supervision, interpretation and report for injection procedure(s) during 30-Sep-08 14-Oct-12
cardiac catheterization; ventricular and/or atrial angiography
93556 Imaging supervision, interpretation and report for injection procedure(s) during 30-Sep-08 14-Oct-12
cardiac catheterization; pulmonary angiography, aortography, and/or selective
coronary angiography including venous bypass grafts and arterial conduits
(whether native or use
93561 Indicator dilution studies such as dye or thermal dilution, including arterial 30-Sep-08 1
and/or venous catheterization; with cardiac output measurement (separate
procedure)
93562 Indicator dilution studies such as dye or thermal dilution, including arterial 30-Sep-08 3
and/or venous catheterization; subsequent measurement of cardiac output
93563 Injection procedure during cardiac catheterization including imaging supervision, 15-Oct-12 1
interpretation, and report; for selective coronary angiography during congenital
heart catheterization (List separately in addition to code for primary procedure)
interpretation, and report; for selective opacification of aortocoronary venous or
arterial bypass graft(s) (eg, aortocoronary saphenous vein, free radial artery, or
free mammary artery graft) to one or more coronary arteries and in situ arterial
conduits (eg, internal mammary), whether native or used for bypass to one or
more coronary arteries during congenital heart catheterization, when performed
interpretation, and report; for selective left ventricular or left atrial angiography
interpretation, and report; for selective right ventricular or right atrial
angiography (List separately in addition to code for primary procedure)
interpretation, and report; for supravalvular aortography (List separately in
interpretation, and report; for pulmonary angiography (List separately in addition
93571 Intravascular Doppler velocity and/or pressure derived coronary flow reserve 30-Sep-08 1
measurement (coronary vessel or graft) during coronary angiography including
pharmacologically induced stress; initial vessel (List separately in addition to
93572 Intravascular Doppler velocity and/or pressure derived coronary flow reserve 30-Sep-08 2
measurement (coronary vessel or graft) during coronary angiography including
pharmacologically induced stress; each additional vessel (List separately in
93580 Percutaneous transcatheter closure of congenital interatrial communication (ie, 30-Sep-08 1

Fontan fenestration, atrial septal defect) with implant
93581 Percutaneous transcatheter closure of a congenital ventricular septal defect with 30-Sep-08 1
implant
93600 Bundle of His recording 30-Sep-08 1
93602 Intra-atrial recording 30-Sep-08 1
93603 Right ventricular recording 30-Sep-08 1
93609 Intraventricular and/or intra-atrial mapping of tachycardia site(s) with catheter 30-Sep-08 1
manipulation to record from multiple sites to identify origin of tachycardia (List
93610 Intra-atrial pacing 30-Sep-08 1

93612 Intraventricular pacing 30-Sep-08 1
93613 Intracardiac electrophysiologic 3-dimensional mapping (List separately in 30-Sep-08 1
93615 Esophageal recording of atrial electrogram with or without ventricular 30-Sep-08 1
electrogram(s);
93616 Esophageal recording of atrial electrogram with or without ventricular 30-Sep-08 1
electrogram(s); with pacing
93618 Induction of arrhythmia by electrical pacing 30-Sep-08 1
93619 Comprehensive electrophysiologic evaluation with right atrial pacing and 30-Sep-08 1
recording, right ventricular pacing and recording, His bundle recording, including
insertion and repositioning of multiple electrode catheters, without induction or
attempted induction of arrhythmia
93620 Comprehensive electrophysiologic evaluation including insertion and 30-Sep-08 1
repositioning of multiple electrode catheters with induction or attempted
induction of arrhythmia; with right atrial pacing and recording, right ventricular
pacing and recording, His bundle recording
induction of arrhythmia; with left atrial pacing and recording from coronary sinus
or left atrium (List separately in addition to code for primary procedure)
induction of arrhythmia; with left ventricular pacing and recording (List
93623 Programmed stimulation and pacing after intravenous drug infusion (List 30-Sep-08 1
93624 Electrophysiologic follow-up study with pacing and recording to test 30-Sep-08 1
effectiveness of therapy, including induction or attempted induction of
arrhythmia
93631 Intra-operative epicardial and endocardial pacing and mapping to localize the 30-Sep-08 1
site of tachycardia or zone of slow conduction for surgical correction
93640 Electrophysiologic evaluation of single or dual chamber pacing cardioverter- 30-Sep-08 1

defibrillator leads including defibrillation threshold evaluation (induction of
arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time
of initial implantation or replacement;

defibrillator leads including defibrillation threshold evaluation (induction of
arrhythmia, evaluation of sensing and pacing for arrhythmia termination) at time
of initial implantation or replacement; with testing of single or dual chamber
pacing cardioverter-defibrillator pulse generator

defibrillator (includes defibrillation threshold evaluation, induction of arrhythmia,
evaluation of sensing and pacing for arrhythmia termination, and programming
or reprogramming of sensing or therapeutic parameters)
93650 Intracardiac catheter ablation of atrioventricular node function, atrioventricular 30-Sep-08 1

conduction for creation of complete heart block, with or without temporary
pacemaker placement
93651 Intracardiac catheter ablation of arrhythmogenic focus; for treatment of 30-Sep-08 1
supraventricular tachycardia by ablation of fast or slow atrioventricular
pathways, accessory atrioventricular connections or other atrial foci, singly or in
combination
93652 Intracardiac catheter ablation of arrhythmogenic focus; for treatment of 30-Sep-08 1
ventricular tachycardia
93660 Evaluation of cardiovascular function with tilt table evaluation, with continuous 30-Sep-08 1
ECG monitoring and intermittent blood pressure monitoring, with or without
pharmacological intervention
93662 Intracardiac echocardiography during therapeutic/diagnostic intervention, 30-Sep-08 1
including imaging supervision and interpretation (List separately in addition to
93668 Peripheral arterial disease (PAD) rehabilitation, per session 30-Sep-08
93701 Bioimpedance-derived physiologic cardiovascular analysis 30-Sep-08 1
93720 Plethysmography, total body; with interpretation and report 30-Sep-08 1
93721 Plethysmography, total body; tracing only, without interpretation and report 30-Sep-08 1
93722 Plethysmography, total body; interpretation and report only 30-Sep-08 1

93724 Electronic analysis of antitachycardia pacemaker system (includes 30-Sep-08 2
electrocardiographic recording, programming of device, induction and
termination of tachycardia via implanted pacemaker, and interpretation of
recordings)
93727 Electronic analysis of implantable loop recorder (ILR) system (includes retrieval 30-Sep-08 14-Oct-12
of recorded and stored ECG data, physician review and interpretation of
retrieved ECG data and reprogramming)
93731 Electronic analysis of dual-chamber pacemaker system (includes evaluation of 30-Sep-08 14-Oct-12
programmable parameters at rest and during activity where applicable, using
electrocardiographic recording and interpretation of recordings at rest and
during exercise, analysis
93732 Electronic analysis of dual-chamber pacemaker system (includes evaluation of 30-Sep-08 14-Oct-12
during exercise, analysis
93733 Electronic analysis of dual chamber internal pacemaker system (may include 30-Sep-08 14-Oct-12
rate, pulse amplitude and duration, configuration of wave form, and/or testing of
sensory function of pacemaker), telephonic analysis
93734 Electronic analysis of single chamber pacemaker system (includes evaluation of 30-Sep-08 14-Oct-12
during exercise, analysi
93735 Electronic analysis of single chamber pacemaker system (includes evaluation of 30-Sep-08 14-Oct-12
during exercise, analysi
93736 Electronic analysis of single chamber internal pacemaker system (may include 30-Sep-08 14-Oct-12
rate, pulse amplitude and duration, configuration of wave form, and/or testing of
sensory function of pacemaker), telephonic analysis
93740 Temperature gradient studies 30-Sep-08

93741 Electronic analysis of pacing cardioverter-defibrillator (includes interrogation, 30-Sep-08 14-Oct-12
evaluation of pulse generator status, evaluation of programmable parameters at
rest and during activity where applicable, using electrocardiographic recording
and interpreta
and interpreta
and interpreta
and interpreta
93745 Initial set-up and programming by a physician of wearable cardioverter- 30-Sep-08 1
defibrillator includes initial programming of system, establishing baseline
electronic ECG, transmission of data to data repository, patient instruction in
wearing system and patient reporting of problems or events
93750 Interrogation of ventricular assist device (VAD), in person, with physician 15-Oct-12
analysis of device parameters (eg, drivelines, alarms, power surges), review of
device function (eg, flow and volume status, septum status, recovery), with
programming, if performed, and report
93760 Thermogram; cephalic 30-Sep-08 14-Oct-12
93762 Thermogram; peripheral 30-Sep-08 14-Oct-12
93770 Determination of venous pressure 30-Sep-08

93784 Ambulatory blood pressure monitoring, utilizing a system such as magnetic tape 30-Sep-08 1
and/or computer disk, for 24 hours or longer; including recording, scanning
analysis, interpretation and report
and/or computer disk, for 24 hours or longer; recording only
and/or computer disk, for 24 hours or longer; scanning analysis with report
and/or computer disk, for 24 hours or longer; physician review with
93797 Physician services for outpatient cardiac rehabilitation; without continuous ECG 30-Sep-08 2
monitoring (per session)
93798 Physician services for outpatient cardiac rehabilitation; with continuous ECG 30-Sep-08 2
monitoring (per session)
93799 Unlisted cardiovascular service or procedure 30-Sep-08
93875 Noninvasive physiologic studies of extracranial arteries, complete bilateral study 30-Sep-08 1
(eg, periorbital flow direction with arterial compression, ocular
pneumoplethysmography, Doppler ultrasound spectral analysis)
93880 Duplex scan of extracranial arteries; complete bilateral study 30-Sep-08 1

93882 Duplex scan of extracranial arteries; unilateral or limited study 30-Sep-08 1
93886 Transcranial Doppler study of the intracranial arteries; complete study 30-Sep-08 1
93888 Transcranial Doppler study of the intracranial arteries; limited study 30-Sep-08 1
93890 Transcranial Doppler study of the intracranial arteries; vasoreactivity study 30-Sep-08 1
93892 Transcranial Doppler study of the intracranial arteries; emboli detection without 30-Sep-08 1
intravenous microbubble injection
93893 Transcranial Doppler study of the intracranial arteries; emboli detection with 30-Sep-08 1
intravenous microbubble injection
93922 Limited bilateral noninvasive physiologic studies of upper or lower extremity 30-Sep-08 1
arteries, (eg, for lower extremity: ankle/brachial indices at distal posterior tibial
and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform
recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior
tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at
1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior
tibial/dorsalis pedis arteries with transcutaneous oxygen tension measurements
at 1-2 levels)
93923 Complete bilateral noninvasive physiologic studies of upper or lower extremity 30-Sep-08 1
arteries, 3 or more levels (eg, for lower extremity: ankle/brachial indices at distal
posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood
pressure measurements with bidirectional Doppler waveform recording and
analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial
and anterior tibial/dorsalis pedis arteries plus segmental volume
plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior
tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous
oxygen tension measurements at 3 or more level(s), or single level study with
provocative functional maneuvers (eg, measurements with postural provocative
tests, or measurements with reactive hyperemia)
93924 Noninvasive physiologic studies of lower extremity arteries, at rest and following 30-Sep-08 1
treadmill stress testing, (ie, bidirectional Doppler waveform or volume
plethysmography recording and analysis at rest with ankle/brachial indices
immediately after and at timed intervals following performance of a
standardized protocol on a motorized treadmill plus recording of time of onset of
claudication or other symptoms, maximal walking time, and time to recovery)
complete bilateral study
93925 Duplex scan of lower extremity arteries or arterial bypass grafts; complete 30-Sep-08 1
bilateral study
93926 Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or 30-Sep-08 1
limited study
93930 Duplex scan of upper extremity arteries or arterial bypass grafts; complete 30-Sep-08 1
bilateral study
93931 Duplex scan of upper extremity arteries or arterial bypass grafts; unilateral or 30-Sep-08 1
limited study
93965 Noninvasive physiologic studies of extremity veins, complete bilateral study (eg, 30-Sep-08 1
Doppler waveform analysis with responses to compression and other maneuvers,
phleborheography, impedance plethysmography)
93970 Duplex scan of extremity veins including responses to compression and other 30-Sep-08 1
maneuvers; complete bilateral study
93971 Duplex scan of extremity veins including responses to compression and other 30-Sep-08 1
maneuvers; unilateral or limited study
93975 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal 30-Sep-08 1
contents and/or retroperitoneal organs; complete study
93976 Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal 30-Sep-08 1
contents and/or retroperitoneal organs; limited study
93978 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; 30-Sep-08 1
complete study
93979 Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; 30-Sep-08 1
unilateral or limited study
93980 Duplex scan of arterial inflow and venous outflow of penile vessels; complete 30-Sep-08 1
study
93981 Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or 30-Sep-08 1
limited study
93982 Noninvasive physiologic study of implanted wireless pressure sensor in 30-Sep-08 1
aneurysmal sac following endovascular repair, complete study including
recording, analysis of pressure and waveform tracings, interpretation and report
93990 Duplex scan of hemodialysis access (including arterial inflow, body of access and 30-Sep-08 2
venous outflow)
94002 Ventilation assist and management, initiation of pressure or volume preset 30-Sep-08 1
ventilators for assisted or controlled breathing; hospital inpatient/observation,
initial day
ventilators for assisted or controlled breathing; hospital inpatient/observation,
each subsequent day
ventilators for assisted or controlled breathing; nursing facility, per day
94005 Home ventilator management care plan oversight of a patient (patient not 30-Sep-08
present) in home, domiciliary or rest home (eg, assisted living) requiring review
of status, review of laboratories and other studies and revision of orders and
respiratory care plan (as appropriate), within a calendar month, 30 minutes or
more
94010 Spirometry, including graphic record, total and timed vital capacity, expiratory 30-Sep-08 1
flow rate measurement(s), with or without maximal voluntary ventilation
94011 Measurement of spirometric forced expiratory flows in an infant or child through 15-Oct-12
2 years of age
94012 Measurement of spirometric forced expiratory flows, before and after 15-Oct-12
bronchodilator, in an infant or child through 2 years of age
94013 Measurement of lung volumes (ie, functional residual capacity [FRC], forced vital 15-Oct-12
capacity [FVC], and expiratory reserve volume [ERV]) in an infant or child
through 2 years of age
94014 Patient-initiated spirometric recording per 30-day period of time; includes 30-Sep-08 1
reinforced education, transmission of spirometric tracing, data capture, analysis
of transmitted data, periodic recalibration and physician review and
interpretation
94015 Patient-initiated spirometric recording per 30-day period of time; recording 30-Sep-08 1
(includes hook-up, reinforced education, data transmission, data capture, trend
analysis, and periodic recalibration)
94016 Patient-initiated spirometric recording per 30-day period of time; physician 30-Sep-08 1
review and interpretation only
94060 Bronchodilation responsiveness, spirometry as in 94010, pre- and post- 30-Sep-08 1
bronchodilator administration
94070 Bronchospasm provocation evaluation, multiple spirometric determinations as in 30-Sep-08 1
94010, with administered agents (eg, antigen[s], cold air, methacholine)
94150 Vital capacity, total (separate procedure) 30-Sep-08

94200 Maximum breathing capacity, maximal voluntary ventilation 30-Sep-08 1
94240 Functional residual capacity or residual volume: helium method, nitrogen open 30-Sep-08 1
circuit method, or other method
94250 Expired gas collection, quantitative, single procedure (separate procedure) 30-Sep-08 1
94260 Thoracic gas volume 30-Sep-08 1

94350 Determination of maldistribution of inspired gas: multiple breath nitrogen 30-Sep-08 1
washout curve including alveolar nitrogen or helium equilibration time
94360 Determination of resistance to airflow, oscillatory or plethysmographic methods 30-Sep-08 1
94370 Determination of airway closing volume, single breath tests 30-Sep-08 1

94375 Respiratory flow volume loop 30-Sep-08 1
94400 Breathing response to CO2 (CO2 response curve) 30-Sep-08 1
94450 Breathing response to hypoxia (hypoxia response curve) 30-Sep-08 1
94452 High altitude simulation test (HAST), with physician interpretation and report; 30-Sep-08 1
94453 High altitude simulation test (HAST), with physician interpretation and report; 30-Sep-08 1
with supplemental oxygen titration
94610 Intrapulmonary surfactant administration by a physician through endotracheal 30-Sep-08 2
tube
94620 Pulmonary stress testing; simple (eg, 6-minute walk test, prolonged exercise test 30-Sep-08 1
for bronchospasm with pre- and post-spirometry and oximetry)
94621 Pulmonary stress testing; complex (including measurements of CO2 production, 30-Sep-08 1
O2 uptake, and electrocardiographic recordings)
94640 Pressurized or nonpressurized inhalation treatment for acute airway obstruction 30-Sep-08
or for sputum induction for diagnostic purposes (eg, with an aerosol generator,
nebulizer, metered dose inhaler or intermittent positive pressure breathing
[IPPB] device)
94642 Aerosol inhalation of pentamidine for pneumocystis carinii pneumonia treatment 30-Sep-08 1
or prophylaxis
94644 Continuous inhalation treatment with aerosol medication for acute airway 30-Sep-08 1
obstruction; first hour
94645 Continuous inhalation treatment with aerosol medication for acute airway 30-Sep-08 2
obstruction; each additional hour (List separately in addition to code for primary
procedure)
94660 Continuous positive airway pressure ventilation (CPAP), initiation and 30-Sep-08 1
management
94662 Continuous negative pressure ventilation (CNP), initiation and management 30-Sep-08 1
94664 Demonstration and/or evaluation of patient utilization of an aerosol generator, 30-Sep-08 1

nebulizer, metered dose inhaler or IPPB device
94667 Manipulation chest wall, such as cupping, percussing, and vibration to facilitate 30-Sep-08 1
lung function; initial demonstration and/or evaluation
94668 Manipulation chest wall, such as cupping, percussing, and vibration to facilitate 30-Sep-08
lung function; subsequent
94680 Oxygen uptake, expired gas analysis; rest and exercise, direct, simple 30-Sep-08 1
94681 Oxygen uptake, expired gas analysis; including CO2 output, percentage oxygen 30-Sep-08 1
extracted
94690 Oxygen uptake, expired gas analysis; rest, indirect (separate procedure) 30-Sep-08 1
94720 Carbon monoxide diffusing capacity (eg, single breath, steady state) 30-Sep-08 1
94725 Membrane diffusion capacity 30-Sep-08 1
94750 Pulmonary compliance study (eg, plethysmography, volume and pressure 30-Sep-08 1
measurements)
94760 Noninvasive ear or pulse oximetry for oxygen saturation; single determination 30-Sep-08 1
94761 Noninvasive ear or pulse oximetry for oxygen saturation; multiple 30-Sep-08 1
determinations (eg, during exercise)
94762 Noninvasive ear or pulse oximetry for oxygen saturation; by continuous 30-Sep-08 1
overnight monitoring (separate procedure)
94770 Carbon dioxide, expired gas determination by infrared analyzer 30-Sep-08 1
94772 Circadian respiratory pattern recording (pediatric pneumogram), 12-24 hour 30-Sep-08 1
continuous recording, infant
94774 Pediatric home apnea monitoring event recording including respiratory rate, 30-Sep-08
pattern and heart rate per 30-day period of time; includes monitor attachment,
download of data, physician review, interpretation, and preparation of a report
94775 Pediatric home apnea monitoring event recording including respiratory rate, 30-Sep-08 1
pattern and heart rate per 30-day period of time; monitor attachment only
(includes hook-up, initiation of recording and disconnection)
pattern and heart rate per 30-day period of time; monitoring, download of
information, receipt of transmission(s) and analyses by computer only
pattern and heart rate per 30-day period of time; physician review,
interpretation and preparation of report only
94799 Unlisted pulmonary service or procedure 30-Sep-08
95004 Percutaneous tests (scratch, puncture, prick) with allergenic extracts, immediate 30-Sep-08
type reaction, including test interpretation and report by a physician, specify
number of tests
95010 Percutaneous tests (scratch, puncture, prick) sequential and incremental, with 30-Sep-08
drugs, biologicals or venoms, immediate type reaction, including test
interpretation and report by a physician, specify number of tests
95012 Nitric oxide expired gas determination 30-Sep-08 2
95015 Intracutaneous (intradermal) tests, sequential and incremental, with drugs, 30-Sep-08
biologicals, or venoms, immediate type reaction, including test interpretation
and report by a physician, specify number of tests
95024 Intracutaneous (intradermal) tests with allergenic extracts, immediate type 30-Sep-08
reaction, including test interpretation and report by a physician, specify number
of tests
95027 Intracutaneous (intradermal) tests, sequential and incremental, with allergenic 30-Sep-08
extracts for airborne allergens, immediate type reaction, including test
interpretation and report by a physician, specify number of tests
95028 Intracutaneous (intradermal) tests with allergenic extracts, delayed type 30-Sep-08
reaction, including reading, specify number of tests
95044 Patch or application test(s) (specify number of tests) 30-Sep-08
95052 Photo patch test(s) (specify number of tests) 30-Sep-08
95056 Photo tests 30-Sep-08 1
95060 Ophthalmic mucous membrane tests 30-Sep-08 1
95065 Direct nasal mucous membrane test 30-Sep-08 1

95070 Inhalation bronchial challenge testing (not including necessary pulmonary 30-Sep-08 1
function tests); with histamine, methacholine, or similar compounds
95071 Inhalation bronchial challenge testing (not including necessary pulmonary 30-Sep-08 1
function tests); with antigens or gases, specify
95075 Ingestion challenge test (sequential and incremental ingestion of test items, eg, 30-Sep-08 1
food, drug or other substance such as metabisulfite)
95115 Professional services for allergen immunotherapy not including provision of 30-Sep-08 1
allergenic extracts; single injection
95117 Professional services for allergen immunotherapy not including provision of 30-Sep-08 1
allergenic extracts; 2 or more injections
95120 Professional services for allergen immunotherapy in prescribing physicians office 30-Sep-08
or institution, including provision of allergenic extract; single injection
or institution, including provision of allergenic extract; 2 or more injections
or institution, including provision of allergenic extract; single stinging insect
venom
or institution, including provision of allergenic extract; 2 stinging insect venoms
95144 Professional services for the supervision of preparation and provision of antigens 30-Sep-08
for allergen immunotherapy, single dose vial(s) (specify number of vials)
for allergen immunotherapy (specify number of doses); single stinging insect
venom
for allergen immunotherapy (specify number of doses); 2 single stinging insect
venoms
venoms
venoms
venoms
for allergen immunotherapy; single or multiple antigens (specify number of
doses)
for allergen immunotherapy; whole body extract of biting insect or other
arthropod (specify number of doses)
95180 Rapid desensitization procedure, each hour (eg, insulin, penicillin, equine serum) 30-Sep-08
95199 Unlisted allergy/clinical immunologic service or procedure 30-Sep-08
95250 Ambulatory continuous glucose monitoring of interstitial tissue fluid via a 30-Sep-08 1
subcutaneous sensor for a minimum of 72 hours; sensor placement, hook-up,
calibration of monitor, patient training, removal of sensor, and printout of
recording
95251 Ambulatory continuous glucose monitoring of interstitial tissue fluid via a 30-Sep-08 1
subcutaneous sensor for a minimum of 72 hours; interpretation and report
95800 Sleep study, unattended, simultaneous recording; heart rate, oxygen saturation, 15-Oct-12
respiratory analysis (eg, by airflow or peripheral arterial tone), and sleep time
95801 Sleep study, unattended, simultaneous recording; minimum of heart rate, 15-Oct-12
oxygen saturation, and respiratory analysis (eg, by airflow or peripheral arterial
tone)
95803 Actigraphy testing, recording, analysis, interpretation, and report (minimum of 15-Oct-12
72 hours to 14 consecutive days of recording)
95805 Multiple sleep latency or maintenance of wakefulness testing, recording, analysis 30-Sep-08 1
and interpretation of physiological measurements of sleep during multiple trials
to assess sleepiness
95806 Sleep study, unattended, simultaneous recording of, heart rate, oxygen 30-Sep-08 1
saturation, respiratory airflow, and respiratory effort (eg, thoracoabdominal
movement)
95807 Sleep study, simultaneous recording of ventilation, respiratory effort, ECG or 30-Sep-08 1
heart rate, and oxygen saturation, attended by a technologist
95808 Polysomnography; sleep staging with 1-3 additional parameters of sleep, 30-Sep-08 1
attended by a technologist
95810 Polysomnography; sleep staging with 4 or more additional parameters of sleep, 30-Sep-08 1
attended by a technologist
95811 Polysomnography; sleep staging with 4 or more additional parameters of sleep, 30-Sep-08 1
with initiation of continuous positive airway pressure therapy or bilevel
ventilation, attended by a technologist
95812 Electroencephalogram (EEG) extended monitoring; 41-60 minutes 30-Sep-08 1
95813 Electroencephalogram (EEG) extended monitoring; greater than 1 hour 30-Sep-08 1
95816 Electroencephalogram (EEG); including recording awake and drowsy 30-Sep-08 1

95819 Electroencephalogram (EEG); including recording awake and asleep 30-Sep-08 1
95822 Electroencephalogram (EEG); recording in coma or sleep only 30-Sep-08 1
95824 Electroencephalogram (EEG); cerebral death evaluation only 30-Sep-08 1
95827 Electroencephalogram (EEG); all night recording 30-Sep-08 1
95829 Electrocorticogram at surgery (separate procedure) 30-Sep-08 1
95830 Insertion by physician of sphenoidal electrodes for electroencephalographic 30-Sep-08 1
(EEG) recording
95831 Muscle testing, manual (separate procedure) with report; extremity (excluding 30-Sep-08
hand) or trunk
95832 Muscle testing, manual (separate procedure) with report; hand, with or without 30-Sep-08 1
comparison with normal side
95833 Muscle testing, manual (separate procedure) with report; total evaluation of 30-Sep-08
body, excluding hands
95834 Muscle testing, manual (separate procedure) with report; total evaluation of 30-Sep-08
body, including hands
95851 Range of motion measurements and report (separate procedure); each extremity 30-Sep-08
(excluding hand) or each trunk section (spine)
95852 Range of motion measurements and report (separate procedure); hand, with or 30-Sep-08 1
without comparison with normal side
95857 Cholinesterase inhibitor challenge test for myasthenia gravis 30-Sep-08 1
95860 Needle electromyography; 1 extremity with or without related paraspinal areas 30-Sep-08 1
95861 Needle electromyography; 2 extremities with or without related paraspinal areas 30-Sep-08 1
95865 Needle electromyography; larynx 30-Sep-08 1

95866 Needle electromyography; hemidiaphragm 30-Sep-08 2
95867 Needle electromyography; cranial nerve supplied muscle(s), unilateral 30-Sep-08 1
95868 Needle electromyography; cranial nerve supplied muscles, bilateral 30-Sep-08 1

95869 Needle electromyography; thoracic paraspinal muscles (excluding T1 or T12) 30-Sep-08 1
95870 Needle electromyography; limited study of muscles in 1 extremity or non-limb 30-Sep-08

(axial) muscles (unilateral or bilateral), other than thoracic paraspinal, cranial
nerve supplied muscles, or sphincters
95872 Needle electromyography using single fiber electrode, with quantitative 30-Sep-08
measurement of jitter, blocking and/or fiber density, any/all sites of each muscle
studied
95873 Electrical stimulation for guidance in conjunction with chemodenervation (List 30-Sep-08 1
95874 Needle electromyography for guidance in conjunction with chemodenervation 30-Sep-08 1

95875 Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) 30-Sep-08 2
metabolite(s)
95900 Nerve conduction, amplitude and latency/velocity study, each nerve; motor, 30-Sep-08
without F-wave study
95903 Nerve conduction, amplitude and latency/velocity study, each nerve; motor, with 30-Sep-08
F-wave study
95904 Nerve conduction, amplitude and latency/velocity study, each nerve; sensory 30-Sep-08
95905 Motor and/or sensory nerve conduction, using preconfigured electrode array(s), 15-Oct-12
amplitude and latency/velocity study, each limb, includes F-wave study when
performed, with interpretation and report
95920 Intraoperative neurophysiology testing, per hour (List separately in addition to 30-Sep-08
95921 Testing of autonomic nervous system function; cardiovagal innervation 30-Sep-08 1
(parasympathetic function), including 2 or more of the following: heart rate
response to deep breathing with recorded R-R interval, Valsalva ratio, and 30:15
ratio
95922 Testing of autonomic nervous system function; vasomotor adrenergic innervation 30-Sep-08 1
(sympathetic adrenergic function), including beat-to-beat blood pressure and R-R
interval changes during Valsalva maneuver and at least 5 minutes of passive tilt
95923 Testing of autonomic nervous system function; sudomotor, including 1 or more of 30-Sep-08 1
the following: quantitative sudomotor axon reflex test (QSART), silastic sweat
imprint, thermoregulatory sweat test, and changes in sympathetic skin potential
95925 Short-latency somatosensory evoked potential study, stimulation of any/all 30-Sep-08 1

peripheral nerves or skin sites, recording from the central nervous system; in
upper limbs
peripheral nerves or skin sites, recording from the central nervous system; in
lower limbs
peripheral nerves or skin sites, recording from the central nervous system; in the
trunk or head
95928 Central motor evoked potential study (transcranial motor stimulation); upper 30-Sep-08 1
limbs
95929 Central motor evoked potential study (transcranial motor stimulation); lower 30-Sep-08 1
limbs
95930 Visual evoked potential (VEP) testing central nervous system, checkerboard or 30-Sep-08 1
flash
95933 Orbicularis oculi (blink) reflex, by electrodiagnostic testing 30-Sep-08 1
95934 H-reflex, amplitude and latency study; record gastrocnemius/soleus muscle 30-Sep-08 1
95936 H-reflex, amplitude and latency study; record muscle other than 30-Sep-08 2
gastrocnemius/soleus muscle
95937 Neuromuscular junction testing (repetitive stimulation, paired stimuli), each 30-Sep-08
nerve, any 1 method
95950 Monitoring for identification and lateralization of cerebral seizure focus, 30-Sep-08 1
electroencephalographic (eg, 8 channel EEG) recording and interpretation, each
24 hours
95951 Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more 30-Sep-08 1
channel telemetry, combined electroencephalographic (EEG) and video
recording and interpretation (eg, for presurgical localization), each 24 hours
95953 Monitoring for localization of cerebral seizure focus by computerized portable 16 30-Sep-08 1
or more channel EEG, electroencephalographic (EEG) recording and
interpretation, each 24 hours, unattended
95954 Pharmacological or physical activation requiring physician attendance during 30-Sep-08 1
EEG recording of activation phase (eg, thiopental activation test)
95955 Electroencephalogram (EEG) during nonintracranial surgery (eg, carotid surgery) 30-Sep-08 1
95956 Monitoring for localization of cerebral seizure focus by cable or radio, 16 or more 30-Sep-08 1
channel telemetry, electroencephalographic (EEG) recording and interpretation,
each 24 hours, attended by a technologist or nurse
95957 Digital analysis of electroencephalogram (EEG) (eg, for epileptic spike analysis) 30-Sep-08 1
95958 Wada activation test for hemispheric function, including electroencephalographic 30-Sep-08 1
(EEG) monitoring
95961 Functional cortical and subcortical mapping by stimulation and/or recording of 30-Sep-08 1
electrodes on brain surface, or of depth electrodes, to provoke seizures or
identify vital brain structures; initial hour of physician attendance
95962 Functional cortical and subcortical mapping by stimulation and/or recording of 30-Sep-08
electrodes on brain surface, or of depth electrodes, to provoke seizures or
identify vital brain structures; each additional hour of physician attendance (List
95965 Magnetoencephalography (MEG), recording and analysis; for spontaneous brain 30-Sep-08 1
magnetic activity (eg, epileptic cerebral cortex localization)
95966 Magnetoencephalography (MEG), recording and analysis; for evoked magnetic 30-Sep-08 1
fields, single modality (eg, sensory, motor, language, or visual cortex
localization)
95967 Magnetoencephalography (MEG), recording and analysis; for evoked magnetic 30-Sep-08 3
fields, each additional modality (eg, sensory, motor, language, or visual cortex
localization) (List separately in addition to code for primary procedure)
95970 Electronic analysis of implanted neurostimulator pulse generator system (eg, 30-Sep-08 1
rate, pulse amplitude and duration, configuration of wave form, battery status,
electrode selectability, output modulation, cycling, impedance and patient
compliance measurements); simple or complex brain, spinal cord, or peripheral
(ie, cranial nerve, peripheral nerve, autonomic nerve, neuromuscular)
neurostimulator pulse generator/transmitter, without reprogramming
compliance measurements); simple spinal cord, or peripheral (ie, peripheral
nerve, autonomic nerve, neuromuscular) neurostimulator pulse
generator/transmitter, with intraoperative or subsequent programming
compliance measurements); complex spinal cord, or peripheral (except cranial
nerve) neurostimulator pulse generator/transmitter, with intraoperative or
subsequent programming, first hour
95973 Electronic analysis of implanted neurostimulator pulse generator system (eg, 30-Sep-08
compliance measurements); complex spinal cord, or peripheral (except cranial
nerve) neurostimulator pulse generator/transmitter, with intraoperative or
subsequent programming, each additional 30 minutes after first hour (List
compliance measurements); complex cranial nerve neurostimulator pulse
generator/transmitter, with intraoperative or subsequent programming, with or
without nerve interface testing, first hour
compliance measurements); complex cranial nerve neurostimulator pulse
generator/transmitter, with intraoperative or subsequent programming, each
additional 30 minutes after first hour (List separately in addition to code for
primary procedure)
rate, pulse amplitude and duration, battery status, electrode selectability and
polarity, impedance and patient compliance measurements), complex deep
brain neurostimulator pulse generator/transmitter, with initial or subsequent
programming; first hour
95979 Electronic analysis of implanted neurostimulator pulse generator system (eg, 30-Sep-08
rate, pulse amplitude and duration, battery status, electrode selectability and
polarity, impedance and patient compliance measurements), complex deep
brain neurostimulator pulse generator/transmitter, with initial or subsequent
programming; each additional 30 minutes after first hour (List separately in
measurements) gastric neurostimulator pulse generator/transmitter;
intraoperative, with programming
subsequent, without reprogramming
subsequent, with reprogramming
95990 Refilling and maintenance of implantable pump or reservoir for drug delivery, 30-Sep-08 2
spinal (intrathecal, epidural) or brain (intraventricular);
spinal (intrathecal, epidural) or brain (intraventricular); administered by
physician
95992 Canalith repositioning procedure(s) (eg, Epley maneuver, Semont maneuver), 15-Oct-12 1
per day
95999 Unlisted neurological or neuromuscular diagnostic procedure 30-Sep-08
96000 Comprehensive computer-based motion analysis by video-taping and 3D 30-Sep-08 1

kinematics;
96001 Comprehensive computer-based motion analysis by video-taping and 3D 30-Sep-08 1
kinematics; with dynamic plantar pressure measurements during walking
96002 Dynamic surface electromyography, during walking or other functional activities, 30-Sep-08 1
1-12 muscles
96003 Dynamic fine wire electromyography, during walking or other functional 30-Sep-08 1
activities, 1 muscle
96004 Physician review and interpretation of comprehensive computer-based motion 30-Sep-08 1
analysis, dynamic plantar pressure measurements, dynamic surface
electromyography during walking or other functional activities, and dynamic fine
wire electromyography, with written report
96020 Neurofunctional testing selection and administration during noninvasive imaging 30-Sep-08 1
functional brain mapping, with test administered entirely by a physician or
psychologist, with review of test results and report
96040 Medical genetics and genetic counseling services, each 30 minutes face-to-face 30-Sep-08
with patient/family
96101 Psychological testing (includes psychodiagnostic assessment of emotionality, 30-Sep-08
intellectual abilities, personality and psychopathology, eg, MMPI, Rorschach,
WAIS), per hour of the psychologist's or physician's time, both face-to-face time
administering tests to the patient and time interpreting these test results and
preparing the report
96102 Psychological testing (includes psychodiagnostic assessment of emotionality, 30-Sep-08

intellectual abilities, personality and psychopathology, eg, MMPI and WAIS), with
qualified health care professional interpretation and report, administered by
technician, per hour of technician time, face-to-face
96103 Psychological testing (includes psychodiagnostic assessment of emotionality, 30-Sep-08 1

intellectual abilities, personality and psychopathology, eg, MMPI), administered
by a computer, with qualified health care professional interpretation and report
96105 Assessment of aphasia (includes assessment of expressive and receptive speech 30-Sep-08
and language function, language comprehension, speech production ability,
reading, spelling, writing, eg, by Boston Diagnostic Aphasia Examination) with
interpretation and report, per hour
96110 Developmental testing; limited (eg, Developmental Screening Test II, Early 30-Sep-08
Language Milestone Screen), with interpretation and report
96111 Developmental testing; extended (includes assessment of motor, language, 30-Sep-08
social, adaptive and/or cognitive functioning by standardized developmental
instruments) with interpretation and report
96116 Neurobehavioral status exam (clinical assessment of thinking, reasoning and 30-Sep-08
judgment, eg, acquired knowledge, attention, language, memory, planning and
problem solving, and visual spatial abilities), per hour of the psychologist's or
physician's time, both face-to-face time with the patient and time interpreting
test results and preparing the report
96118 Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, 30-Sep-08

Wechsler Memory Scales and Wisconsin Card Sorting Test), per hour of the
psychologist's or physician's time, both face-to-face time administering tests to
the patient and time interpreting these test results and preparing the report
96119 Neuropsychological testing (eg, Halstead-Reitan Neuropsychological Battery, 30-Sep-08

Wechsler Memory Scales and Wisconsin Card Sorting Test), with qualified health
care professional interpretation and report, administered by technician, per hour
of technician time, face-to-face
96120 Neuropsychological testing (eg, Wisconsin Card Sorting Test), administered by a 30-Sep-08 1
computer, with qualified health care professional interpretation and report
96125 Standardized cognitive performance testing (eg, Ross Information Processing 30-Sep-08 2
Assessment) per hour of a qualified health care professional's time, both face-to-
face time administering tests to the patient and time interpreting these test
results and preparing the report
96150 Health and behavior assessment (eg, health-focused clinical interview, 30-Sep-08
behavioral observations, psychophysiological monitoring, health-oriented
questionnaires), each 15 minutes face-to-face with the patient; initial
assessment
96151 Health and behavior assessment (eg, health-focused clinical interview, 30-Sep-08
behavioral observations, psychophysiological monitoring, health-oriented
questionnaires), each 15 minutes face-to-face with the patient; re-assessment
96152 Health and behavior intervention, each 15 minutes, face-to-face; individual 30-Sep-08
96153 Health and behavior intervention, each 15 minutes, face-to-face; group (2 or 30-Sep-08
more patients)
96154 Health and behavior intervention, each 15 minutes, face-to-face; family (with the 30-Sep-08
patient present)
96155 Health and behavior intervention, each 15 minutes, face-to-face; family (without 30-Sep-08
the patient present)
96360 Intravenous infusion, hydration; initial, 31 minutes to 1 hour 15-Oct-12 2
96361 Intravenous infusion, hydration; each additional hour (List separately in addition 15-Oct-12
96365 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or 15-Oct-12
drug); initial, up to 1 hour
drug); each additional hour (List separately in addition to code for primary
procedure)
drug); additional sequential infusion, up to 1 hour (List separately in addition to
96368 Intravenous infusion, for therapy, prophylaxis, or diagnosis (specify substance or 15-Oct-12 2
drug); concurrent infusion (List separately in addition to code for primary
procedure)
96369 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); 15-Oct-12 1
initial, up to 1 hour, including pump set-up and establishment of subcutaneous
infusion site(s)
96370 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); 15-Oct-12
each additional hour (List separately in addition to code for primary procedure)
96371 Subcutaneous infusion for therapy or prophylaxis (specify substance or drug); 15-Oct-12 1
additional pump set-up with establishment of new subcutaneous infusion site(s)
96372 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); 15-Oct-12

subcutaneous or intramuscular
96373 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); 15-Oct-12 2
intra-arterial
96374 Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); 15-Oct-12 2
intravenous push, single or initial substance/drug
each additional sequential intravenous push of a new substance/drug (List

each additional sequential intravenous push of the same substance/drug
provided in a facility (List separately in addition to code for primary procedure)
96379 Unlisted therapeutic, prophylactic, or diagnostic intravenous or intra-arterial 15-Oct-12

injection or infusion
96401 Chemotherapy administration, subcutaneous or intramuscular; non-hormonal 30-Sep-08
anti-neoplastic
96402 Chemotherapy administration, subcutaneous or intramuscular; hormonal anti- 30-Sep-08 2
neoplastic
96405 Chemotherapy administration; intralesional, up to and including 7 lesions 30-Sep-08 1
96406 Chemotherapy administration; intralesional, more than 7 lesions 30-Sep-08 1

96409 Chemotherapy administration; intravenous, push technique, single or initial 30-Sep-08 2
substance/drug
96411 Chemotherapy administration; intravenous, push technique, each additional 30-Sep-08
substance/drug (List separately in addition to code for primary procedure)
96413 Chemotherapy administration, intravenous infusion technique; up to 1 hour, 30-Sep-08 2

single or initial substance/drug
96415 Chemotherapy administration, intravenous infusion technique; each additional 30-Sep-08
hour (List separately in addition to code for primary procedure)
96416 Chemotherapy administration, intravenous infusion technique; initiation of 30-Sep-08 1

prolonged chemotherapy infusion (more than 8 hours), requiring use of a
portable or implantable pump
96417 Chemotherapy administration, intravenous infusion technique; each additional 30-Sep-08
sequential infusion (different substance/drug), up to 1 hour (List separately in
96420 Chemotherapy administration, intra-arterial; push technique 30-Sep-08 2
96422 Chemotherapy administration, intra-arterial; infusion technique, up to 1 hour 30-Sep-08 2
96423 Chemotherapy administration, intra-arterial; infusion technique, each additional 30-Sep-08

hour (List separately in addition to code for primary procedure)
96425 Chemotherapy administration, intra-arterial; infusion technique, initiation of 30-Sep-08 1

prolonged infusion (more than 8 hours), requiring the use of a portable or
implantable pump
96440 Chemotherapy administration into pleural cavity, requiring and including 30-Sep-08 1
thoracentesis
96445 Chemotherapy administration into peritoneal cavity, requiring and including 30-Sep-08 14-Oct-12
peritoneocentesis
96446 Chemotherapy administration into the peritoneal cavity via indwelling port or 15-Oct-12 1
catheter
96450 Chemotherapy administration, into CNS (eg, intrathecal), requiring and including 30-Sep-08 1
spinal puncture
96521 Refilling and maintenance of portable pump 30-Sep-08 2
systemic (eg, intravenous, intra-arterial)
96523 Irrigation of implanted venous access device for drug delivery systems 30-Sep-08 1
96542 Chemotherapy injection, subarachnoid or intraventricular via subcutaneous 30-Sep-08 1

reservoir, single or multiple agents
96549 Unlisted chemotherapy procedure 30-Sep-08
96567 Photodynamic therapy by external application of light to destroy premalignant 30-Sep-08 1

and/or malignant lesions of the skin and adjacent mucosa (eg, lip) by activation
of photosensitive drug(s), each phototherapy exposure session
96570 Photodynamic therapy by endoscopic application of light to ablate abnormal 30-Sep-08 1

tissue via activation of photosensitive drug(s); first 30 minutes (List separately in
addition to code for endoscopy or bronchoscopy procedures of lung and
gastrointestinal tract)
96571 Photodynamic therapy by endoscopic application of light to ablate abnormal 30-Sep-08 3
tissue via activation of photosensitive drug(s); each additional 15 minutes (List
separately in addition to code for endoscopy or bronchoscopy procedures of lung
and gastrointestinal tract)
96900 Actinotherapy (ultraviolet light) 30-Sep-08 1

96902 Microscopic examination of hairs plucked or clipped by the examiner (excluding 30-Sep-08
hair collected by the patient) to determine telogen and anagen counts, or
structural hair shaft abnormality
96904 Whole body integumentary photography, for monitoring of high risk patients 30-Sep-08 1
with dysplastic nevus syndrome or a history of dysplastic nevi, or patients with a
personal or familial history of melanoma
96910 Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum 30-Sep-08 1
and ultraviolet B
96912 Photochemotherapy; psoralens and ultraviolet A (PUVA) 30-Sep-08 1
96913 Photochemotherapy (Goeckerman and/or PUVA) for severe photoresponsive 30-Sep-08 1
dermatoses requiring at least 4-8 hours of care under direct supervision of the
physician (includes application of medication and dressings)
96920 Laser treatment for inflammatory skin disease (psoriasis); total area less than 30-Sep-08 1
250 sq cm
96921 Laser treatment for inflammatory skin disease (psoriasis); 250 sq cm to 500 sq 30-Sep-08 1
cm
96922 Laser treatment for inflammatory skin disease (psoriasis); over 500 sq cm 30-Sep-08 1
96999 Unlisted special dermatological service or procedure 30-Sep-08
97001 Physical therapy evaluation 30-Sep-08

97002 Physical therapy re-evaluation 30-Sep-08
97003 Occupational therapy evaluation 30-Sep-08
97004 Occupational therapy re-evaluation 30-Sep-08
97005 Athletic training evaluation 30-Sep-08
97006 Athletic training re-evaluation 30-Sep-08
97010 Application of a modality to 1 or more areas; hot or cold packs 30-Sep-08

97012 Application of a modality to 1 or more areas; traction, mechanical 30-Sep-08 1
97014 Application of a modality to 1 or more areas; electrical stimulation (unattended) 30-Sep-08
97016 Application of a modality to 1 or more areas; vasopneumatic devices 30-Sep-08 1

97018 Application of a modality to 1 or more areas; paraffin bath 30-Sep-08 1
97022 Application of a modality to 1 or more areas; whirlpool 30-Sep-08 1
97024 Application of a modality to 1 or more areas; diathermy (eg, microwave) 30-Sep-08 1
97026 Application of a modality to 1 or more areas; infrared 30-Sep-08 1

97028 Application of a modality to 1 or more areas; ultraviolet 30-Sep-08 1
97032 Application of a modality to 1 or more areas; electrical stimulation (manual), 30-Sep-08
each 15 minutes
97033 Application of a modality to 1 or more areas; iontophoresis, each 15 minutes 30-Sep-08
97034 Application of a modality to 1 or more areas; contrast baths, each 15 minutes 30-Sep-08
97035 Application of a modality to 1 or more areas; ultrasound, each 15 minutes 30-Sep-08
97036 Application of a modality to 1 or more areas; Hubbard tank, each 15 minutes 30-Sep-08
97039 Unlisted modality (specify type and time if constant attendance) 30-Sep-08
97110 Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises 30-Sep-08
to develop strength and endurance, range of motion and flexibility
97112 Therapeutic procedure, 1 or more areas, each 15 minutes; neuromuscular 30-Sep-08

reeducation of movement, balance, coordination, kinesthetic sense, posture,
and/or proprioception for sitting and/or standing activities
97113 Therapeutic procedure, 1 or more areas, each 15 minutes; aquatic therapy with 30-Sep-08
therapeutic exercises
97116 Therapeutic procedure, 1 or more areas, each 15 minutes; gait training (includes 30-Sep-08
stair climbing)
97124 Therapeutic procedure, 1 or more areas, each 15 minutes; massage, including 30-Sep-08
effleurage, petrissage and/or tapotement (stroking, compression, percussion)
97139 Unlisted therapeutic procedure (specify) 30-Sep-08
97140 Manual therapy techniques (eg, mobilization/ manipulation, manual lymphatic 30-Sep-08
drainage, manual traction), 1 or more regions, each 15 minutes
97150 Therapeutic procedure(s), group (2 or more individuals) 30-Sep-08 1

97530 Therapeutic activities, direct (one-on-one) patient contact by the provider (use 30-Sep-08
of dynamic activities to improve functional performance), each 15 minutes
97532 Development of cognitive skills to improve attention, memory, problem solving 30-Sep-08
(includes compensatory training), direct (one-on-one) patient contact by the
provider, each 15 minutes
97533 Sensory integrative techniques to enhance sensory processing and promote 30-Sep-08
adaptive responses to environmental demands, direct (one-on-one) patient
contact by the provider, each 15 minutes
97535 Self-care/home management training (eg, activities of daily living (ADL) and 30-Sep-08
compensatory training, meal preparation, safety procedures, and instructions in
use of assistive technology devices/adaptive equipment) direct one-on-one
contact by provider, each 15 minutes
97537 Community/work reintegration training (eg, shopping, transportation, money 30-Sep-08

management, avocational activities and/or work environment/modification
analysis, work task analysis, use of assistive technology device/adaptive
equipment), direct one-on-one contact by provider, each 15 minutes
97542 Wheelchair management (eg, assessment, fitting, training), each 15 minutes 30-Sep-08
97545 Work hardening/conditioning; initial 2 hours 30-Sep-08 1

97546 Work hardening/conditioning; each additional hour (List separately in addition to 30-Sep-08 2
97597 Debridement (eg, high pressure waterjet with/without suction, sharp selective 30-Sep-08 1
debridement with scissors, scalpel and forceps), open wound, (eg, fibrin,
devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical
application(s), wound assessment, use of a whirlpool, when performed and
instruction(s) for ongoing care, per session, total wound(s) surface area; first 20
sq cm or less
97598 Debridement (eg, high pressure waterjet with/without suction, sharp selective 30-Sep-08
debridement with scissors, scalpel and forceps), open wound, (eg, fibrin,
devitalized epidermis and/or dermis, exudate, debris, biofilm), including topical
application(s), wound assessment, use of a whirlpool, when performed and
instruction(s) for ongoing care, per session, total wound(s) surface area; each
additional 20 sq cm, or part thereof (List separately in addition to code for
primary procedure)
97602 Removal of devitalized tissue from wound(s), non-selective debridement, without 30-Sep-08
anesthesia (eg, wet-to-moist dressings, enzymatic, abrasion), including topical
application(s), wound assessment, and instruction(s) for ongoing care, per
session
97605 Negative pressure wound therapy (eg, vacuum assisted drainage collection), 30-Sep-08 1
including topical application(s), wound assessment, and instruction(s) for
ongoing care, per session; total wound(s) surface area less than or equal to 50
square centimeters
97606 Negative pressure wound therapy (eg, vacuum assisted drainage collection), 30-Sep-08 1
including topical application(s), wound assessment, and instruction(s) for
ongoing care, per session; total wound(s) surface area greater than 50 square
centimeters
97750 Physical performance test or measurement (eg, musculoskeletal, functional 30-Sep-08
capacity), with written report, each 15 minutes
97755 Assistive technology assessment (eg, to restore, augment or compensate for 30-Sep-08
existing function, optimize functional tasks and/or maximize environmental
accessibility), direct one-on-one contact by provider, with written report, each 15
minutes
97760 Orthotic(s) management and training (including assessment and fitting when not 30-Sep-08
otherwise reported), upper extremity(s), lower extremity(s) and/or trunk, each
15 minutes
97761 Prosthetic training, upper and/or lower extremity(s), each 15 minutes 30-Sep-08
97762 Checkout for orthotic/prosthetic use, established patient, each 15 minutes 30-Sep-08
97799 Unlisted physical medicine/rehabilitation service or procedure 30-Sep-08
97802 Medical nutrition therapy; initial assessment and intervention, individual, face- 30-Sep-08
to-face with the patient, each 15 minutes
97803 Medical nutrition therapy; re-assessment and intervention, individual, face-to- 30-Sep-08
face with the patient, each 15 minutes
97804 Medical nutrition therapy; group (2 or more individual(s)), each 30 minutes 30-Sep-08
97810 Acupuncture, 1 or more needles; without electrical stimulation, initial 15 minutes 30-Sep-08
of personal one-on-one contact with the patient
97811 Acupuncture, 1 or more needles; without electrical stimulation, each additional 30-Sep-08
15 minutes of personal one-on-one contact with the patient, with re-insertion of
needle(s) (List separately in addition to code for primary procedure)
97813 Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of 30-Sep-08
personal one-on-one contact with the patient
97814 Acupuncture, 1 or more needles; with electrical stimulation, each additional 15 30-Sep-08
minutes of personal one-on-one contact with the patient, with re-insertion of
needle(s) (List separately in addition to code for primary procedure)
98925 Osteopathic manipulative treatment (OMT); 1-2 body regions involved 30-Sep-08 1
98940 Chiropractic manipulative treatment (CMT); spinal, 1-2 regions 30-Sep-08 1
98941 Chiropractic manipulative treatment (CMT); spinal, 3-4 regions 30-Sep-08 1
98942 Chiropractic manipulative treatment (CMT); spinal, 5 regions 30-Sep-08 1
98943 Chiropractic manipulative treatment (CMT); extraspinal, 1 or more regions 30-Sep-08
98960 Education and training for patient self-management by a qualified, nonphysician 30-Sep-08
health care professional using a standardized curriculum, face-to-face with the
patient (could include caregiver/family) each 30 minutes; individual patient
patient (could include caregiver/family) each 30 minutes; 2-4 patients
patient (could include caregiver/family) each 30 minutes; 5-8 patients
98966 Telephone assessment and management service provided by a qualified 30-Sep-08

nonphysician health care professional to an established patient, parent, or
guardian not originating from a related assessment and management service
provided within the previous 7 days nor leading to an assessment and
management service or procedure within the next 24 hours or soonest available
appointment; 5-10 minutes of medical discussion


98969 Online assessment and management service provided by a qualified 30-Sep-08
nonphysician health care professional to an established patient, guardian, or
health care provider not originating from a related assessment and management
service provided within the previous 7 days, using the Internet or similar
electronic communications network
99000 Handling and/or conveyance of specimen for transfer from the physician's office 30-Sep-08
to a laboratory
99001 Handling and/or conveyance of specimen for transfer from the patient in other 30-Sep-08
than a physician's office to a laboratory (distance may be indicated)
99002 Handling, conveyance, and/or any other service in connection with the 30-Sep-08
implementation of an order involving devices (eg, designing, fitting, packaging,
handling, delivery or mailing) when devices such as orthotics, protectives,
prosthetics are fabricated by an outside laboratory or shop but which items have
been designed, and are to be fitted and adjusted by the attending physician
99024 Postoperative follow-up visit, normally included in the surgical package, to 30-Sep-08
indicate that an evaluation and management service was performed during a
postoperative period for a reason(s) related to the original procedure
99026 Hospital mandated on call service; in-hospital, each hour 30-Sep-08
99027 Hospital mandated on call service; out-of-hospital, each hour 30-Sep-08
99050 Services provided in the office at times other than regularly scheduled office 30-Sep-08
hours, or days when the office is normally closed (eg, holidays, Saturday or
Sunday), in addition to basic service
99051 Service(s) provided in the office during regularly scheduled evening, weekend, 30-Sep-08
or holiday office hours, in addition to basic service
99053 Service(s) provided between 10:00 PM and 8:00 AM at 24-hour facility, in 30-Sep-08
addition to basic service
99056 Service(s) typically provided in the office, provided out of the office at request of 30-Sep-08
patient, in addition to basic service
99058 Service(s) provided on an emergency basis in the office, which disrupts other 30-Sep-08
scheduled office services, in addition to basic service
99060 Service(s) provided on an emergency basis, out of the office, which disrupts 30-Sep-08
other scheduled office services, in addition to basic service
99070 Supplies and materials (except spectacles), provided by the physician over and 30-Sep-08
above those usually included with the office visit or other services rendered (list
drugs, trays, supplies, or materials provided)
99071 Educational supplies, such as books, tapes, and pamphlets, provided by the 30-Sep-08
physician for the patient's education at cost to physician
99075 Medical testimony 30-Sep-08
99078 Physician educational services rendered to patients in a group setting (eg, 30-Sep-08
prenatal, obesity, or diabetic instructions)
99080 Special reports such as insurance forms, more than the information conveyed in 30-Sep-08
the usual medical communications or standard reporting form
99082 Unusual travel (eg, transportation and escort of patient) 30-Sep-08 1
99090 Analysis of clinical data stored in computers (eg, ECGs, blood pressures, 30-Sep-08
hematologic data)
99091 Collection and interpretation of physiologic data (eg, ECG, blood pressure, 30-Sep-08
glucose monitoring) digitally stored and/or transmitted by the patient and/or
caregiver to the physician or other qualified health care professional, requiring a
minimum of 30 minutes of time
99100 Anesthesia for patient of extreme age, younger than 1 year and older than 70 30-Sep-08
(List separately in addition to code for primary anesthesia procedure)
99116 Anesthesia complicated by utilization of total body hypothermia (List separately 30-Sep-08
in addition to code for primary anesthesia procedure)
99135 Anesthesia complicated by utilization of controlled hypotension (List separately 30-Sep-08
in addition to code for primary anesthesia procedure)
99140 Anesthesia complicated by emergency conditions (specify) (List separately in 30-Sep-08
addition to code for primary anesthesia procedure)
99143 Moderate sedation services (other than those services described by codes 30-Sep-08 2
00100-01999) provided by the same physician performing the diagnostic or
therapeutic service that the sedation supports, requiring the presence of an
independent trained observer to assist in the monitoring of the patient's level of
consciousness and physiological status; younger than 5 years of age, first 30
minutes intra-service time
consciousness and physiological status; age 5 years or older, first 30 minutes
intra-service time
99145 Moderate sedation services (other than those services described by codes 30-Sep-08
consciousness and physiological status; each additional 15 minutes intra-service
time (List separately in addition to code for primary service)
00100-01999), provided by a physician other than the health care professional
performing the diagnostic or therapeutic service that the sedation supports;
younger than 5 years of age, first 30 minutes intra-service time
performing the diagnostic or therapeutic service that the sedation supports; age
5 years or older, first 30 minutes intra-service time
99150 Moderate sedation services (other than those services described by codes 30-Sep-08
performing the diagnostic or therapeutic service that the sedation supports;
each additional 15 minutes intra-service time (List separately in addition to code
for primary service)
99170 Anogenital examination with colposcopic magnification in childhood for 30-Sep-08 1

suspected trauma
99172 Visual function screening, automated or semi-automated bilateral quantitative 30-Sep-08
determination of visual acuity, ocular alignment, color vision by
pseudoisochromatic plates, and field of vision (may include all or some screening
of the determination[s] for contrast sensitivity, vision under glare)
99173 Screening test of visual acuity, quantitative, bilateral 30-Sep-08

99174 Ocular photoscreening with interpretation and report, bilateral 30-Sep-08
99175 Ipecac or similar administration for individual emesis and continued observation 30-Sep-08 1
until stomach adequately emptied of poison
99183 Physician attendance and supervision of hyperbaric oxygen therapy, per session 30-Sep-08 1
99185 Hypothermia; regional 30-Sep-08 14-Oct-12

99186 Hypothermia; total body 30-Sep-08 14-Oct-12
99190 Assembly and operation of pump with oxygenator or heat exchanger (with or 30-Sep-08
without ECG and/or pressure monitoring); each hour
99191 Assembly and operation of pump with oxygenator or heat exchanger (with or 30-Sep-08 1
without ECG and/or pressure monitoring); 45 minutes
99192 Assembly and operation of pump with oxygenator or heat exchanger (with or 30-Sep-08 1
without ECG and/or pressure monitoring); 30 minutes
99195 Phlebotomy, therapeutic (separate procedure) 30-Sep-08 2
99199 Unlisted special service, procedure or report 30-Sep-08
99201 Office or other outpatient visit for the evaluation and management of a new 30-Sep-08 1
patient, which requires these 3 key components: A problem focused history; A
problem focused examination; Straightforward medical decision making.
Counseling and/or coordination of care with other providers or agencies are
provided consistent with the nature of the problem(s) and the patient's and/or
family's needs. Usually, the presenting problem(s) are self limited or minor.
Physicians typically spend 10 minutes face-to-face with the patient and/or family.
patient, which requires these 3 key components: An expanded problem focused
history; An expanded problem focused examination; Straightforward medical
decision making. Counseling and/or coordination of care with other providers or
agencies are provided consistent with the nature of the problem(s) and the
patient's and/or family's needs. Usually, the presenting problem(s) are of low to
moderate severity. Physicians typically spend 20 minutes face-to-face with the
patient and/or family.
patient, which requires these 3 key components: A detailed history; A detailed
examination; Medical decision making of low complexity. Counseling and/or
coordination of care with other providers or agencies are provided consistent
with the nature of the problem(s) and the patient's and/or family's needs.
Usually, the presenting problem(s) are of moderate severity. Physicians typically
spend 30 minutes face-to-face with the patient and/or family.
patient, which requires these 3 key components: A comprehensive history; A
comprehensive examination; Medical decision making of moderate complexity.
family's needs. Usually, the presenting problem(s) are of moderate to high
severity. Physicians typically spend 45 minutes face-to-face with the patient
and/or family.
comprehensive examination; Medical decision making of high complexity.
family's needs. Usually, the presenting problem(s) are of moderate to high
severity. Physicians typically spend 60 minutes face-to-face with the patient
and/or family.
99211 Office or other outpatient visit for the evaluation and management of an 30-Sep-08 1
established patient, that may not require the presence of a physician. Usually,
the presenting problem(s) are minimal. Typically, 5 minutes are spent performing
or supervising these services.
established patient, which requires at least 2 of these 3 key components: A
problem focused history; A problem focused examination; Straightforward
medical decision making. Counseling and/or coordination of care with other
providers or agencies are provided consistent with the nature of the problem(s)
and the patient's and/or family's needs. Usually, the presenting problem(s) are
self limited or minor. Physicians typically spend 10 minutes face-to-face with the
established patient, which requires at least 2 of these 3 key components: An
expanded problem focused history; An expanded problem focused examination;
Medical decision making of low complexity. Counseling and coordination of care
with other providers or agencies are provided consistent with the nature of the
problem(s) and the patient's and/or family's needs. Usually, the presenting
problem(s) are of low to moderate severity. Physicians typically spend 15
minutes face-to-face with the patient and/or family.
detailed history; A detailed examination; Medical decision making of moderate
complexity. Counseling and/or coordination of care with other providers or
patient's and/or family's needs. Usually, the presenting problem(s) are of
moderate to high severity. Physicians typically spend 25 minutes face-to-face
with the patient and/or family.
comprehensive history; A comprehensive examination; Medical decision making
of high complexity. Counseling and/or coordination of care with other providers
or agencies are provided consistent with the nature of the problem(s) and the
moderate to high severity. Physicians typically spend 40 minutes face-to-face
99217 Observation care discharge day management (This code is to be utilized by the 30-Sep-08
physician to report all services provided to a patient on discharge from
"observation status" if the discharge is on other than the initial date of
"observation status." To report services to a patient designated as "observation
status" or "inpatient status" and discharged on the same date, use the codes for
Observation or Inpatient Care Services [including Admission and Discharge
Services, 99234-99236 as appropriate.])
99218 Initial observation care, per day, for the evaluation and management of a patient 30-Sep-08
which requires these 3 key components: A detailed or comprehensive history; A
detailed or comprehensive examination; and Medical decision making that is
straightforward or of low complexity. Counseling and/or coordination of care with
other providers or agencies are provided consistent with the nature of the
problem(s) and the patient's and/or family's needs. Usually, the problem(s)
requiring admission to "observation status" are of low severity.
99219 Initial observation care, per day, for the evaluation and management of a 30-Sep-08
comprehensive examination; and Medical decision making of moderate
patient's and/or family's needs. Usually, the problem(s) requiring admission to
"observation status" are of moderate severity.
99220 Initial observation care, per day, for the evaluation and management of a 30-Sep-08
comprehensive examination; and Medical decision making of high complexity.
family's needs. Usually, the problem(s) requiring admission to "observation
status" are of high severity.
99221 Initial hospital care, per day, for the evaluation and management of a patient, 30-Sep-08 1
which requires these 3 key components: A detailed or comprehensive history; A
detailed or comprehensive examination; and Medical decision making that is
problem(s) and the patient's and/or family's needs. Usually, the problem(s)
requiring admission are of low severity. Physicians typically spend 30 minutes at
the bedside and on the patient's hospital floor or unit.
which requires these 3 key components: A comprehensive history; A
patient's and/or family's needs. Usually, the problem(s) requiring admission are
of moderate severity. Physicians typically spend 50 minutes at the bedside and
on the patient's hospital floor or unit.
which requires these 3 key components: A comprehensive history; A
family's needs. Usually, the problem(s) requiring admission are of high severity.
Physicians typically spend 70 minutes at the bedside and on the patient's
hospital floor or unit.
99224 Subsequent observation care, per day, for the evaluation and management of a 15-Oct-12 1
patient, which requires at least 2 of these 3 key components: Problem focused
interval history; Problem focused examination; Medical decision making that is
problem(s) and the patient's and/or family's needs. Usually, the patient is stable,
recovering, or improving. Physicians typically spend 15 minutes at the bedside
and on the patient's hospital floor or unit.
patient, which requires at least 2 of these 3 key components: An expanded
problem focused interval history; An expanded problem focused examination;
Medical decision making of moderate complexity. Counseling and/or coordination
of care with other providers or agencies are provided consistent with the nature
of the problem(s) and the patient's and/or family's needs. Usually, the patient is
responding inadequately to therapy or has developed a minor complication.
patient, which requires at least 2 of these 3 key components: A detailed interval
history; A detailed examination; Medical decision making of high complexity.
family's needs. Usually, the patient is unstable or has developed a significant
complication or a significant new problem. Physicians typically spend 35 minutes
at the bedside and on the patient's hospital floor or unit.
99231 Subsequent hospital care, per day, for the evaluation and management of a 30-Sep-08 1
patient, which requires at least 2 of these 3 key components: A problem focused
interval history; A problem focused examination; Medical decision making that is
problem(s) and the patient's and/or family's needs. Usually, the patient is stable,
recovering or improving. Physicians typically spend 15 minutes at the bedside
and on the patient's hospital floor or unit.
patient, which requires at least 2 of these 3 key components: An expanded
of the problem(s) and the patient's and/or family's needs. Usually, the patient is
patient, which requires at least 2 of these 3 key components: A detailed interval
history; A detailed examination; Medical decision making of high complexity.
at the bedside and on the patient's hospital floor or unit.
99234 Observation or inpatient hospital care, for the evaluation and management of a 30-Sep-08 1
patient including admission and discharge on the same date, which requires
these 3 key components: A detailed or comprehensive history; A detailed or
comprehensive examination; and Medical decision making that is
problem(s) and the patient's and/or family's needs. Usually the presenting
problem(s) requiring admission are of low severity.
these 3 key components: A comprehensive history; A comprehensive
examination; and Medical decision making of moderate complexity. Counseling
and/or coordination of care with other providers or agencies are provided
consistent with the nature of the problem(s) and the patient's and/or family's
needs. Usually the presenting problem(s) requiring admission are of moderate
severity.
examination; and Medical decision making of high complexity. Counseling and/or
Usually the presenting problem(s) requiring admission are of high severity.
99238 Hospital discharge day management; 30 minutes or less 30-Sep-08
99239 Hospital discharge day management; more than 30 minutes 30-Sep-08
99241 Office consultation for a new or established patient, which requires these 3 key 30-Sep-08
components: A problem focused history; A problem focused examination; and
Straightforward medical decision making. Counseling and/or coordination of care
problem(s) are self limited or minor. Physicians typically spend 15 minutes face-
to-face with the patient and/or family.
components: An expanded problem focused history; An expanded problem
focused examination; and Straightforward medical decision making. Counseling
needs. Usually, the presenting problem(s) are of low severity. Physicians
typically spend 30 minutes face-to-face with the patient and/or family.
components: A detailed history; A detailed examination; and Medical decision
making of low complexity. Counseling and/or coordination of care with other
of moderate severity. Physicians typically spend 40 minutes face-to-face with the
components: A comprehensive history; A comprehensive examination; and
of the problem(s) and the patient's and/or family's needs. Usually, the
presenting problem(s) are of moderate to high severity. Physicians typically
spend 60 minutes face-to-face with the patient and/or family.
components: A comprehensive history; A comprehensive examination; and
Medical decision making of high complexity. Counseling and/or coordination of
care with other providers or agencies are provided consistent with the nature of
the problem(s) and the patient's and/or family's needs. Usually, the presenting
problem(s) are of moderate to high severity. Physicians typically spend 80
99251 Inpatient consultation for a new or established patient, which requires these 3 30-Sep-08
key components: A problem focused history; A problem focused examination;
and Straightforward medical decision making. Counseling and/or coordination of
problem(s) are self limited or minor. Physicians typically spend 20 minutes at the
bedside and on the patient's hospital floor or unit.
key components: An expanded problem focused history; An expanded problem
needs. Usually, the presenting problem(s) are of low severity. Physicians
typically spend 40 minutes at the bedside and on the patient's hospital floor or
unit.
key components: A detailed history; A detailed examination; and Medical
decision making of low complexity. Counseling and/or coordination of care with
problem(s) are of moderate severity. Physicians typically spend 55 minutes at
the bedside and on the patient's hospital floor or unit.
key components: A comprehensive history; A comprehensive examination; and
of the problem(s) and the patient's and/or family's needs. Usually, the
presenting problem(s) are of moderate to high severity. Physicians typically
spend 80 minutes at the bedside and on the patient's hospital floor or unit.
key components: A comprehensive history; A comprehensive examination; and
Medical decision making of high complexity. Counseling and/or coordination of
minutes at the bedside and on the patient's hospital floor or unit.
99281 Emergency department visit for the evaluation and management of a patient, 30-Sep-08 1
which requires these 3 key components: A problem focused history; A problem
needs. Usually, the presenting problem(s) are self limited or minor.
which requires these 3 key components: An expanded problem focused history;
An expanded problem focused examination; and Medical decision making of low
patient's and/or family's needs. Usually, the presenting problem(s) are of low to
moderate severity.
which requires these 3 key components: An expanded problem focused history;
An expanded problem focused examination; and Medical decision making of
moderate complexity. Counseling and/or coordination of care with other
of moderate severity.
which requires these 3 key components: A detailed history; A detailed
needs. Usually, the presenting problem(s) are of high severity, and require
urgent evaluation by the physician but do not pose an immediate significant
threat to life or physiologic function.
which requires these 3 key components within the constraints imposed by the
urgency of the patient's clinical condition and/or mental status: A comprehensive
history; A comprehensive examination; and Medical decision making of high
patient's and/or family's needs. Usually, the presenting problem(s) are of high
severity and pose an immediate significant threat to life or physiologic function.
99288 Physician direction of emergency medical systems (EMS) emergency care, 30-Sep-08
advanced life support
99289 Critical care services delivered by a physician, face-to-face, during an 30-Sep-08 14-Oct-12
interfacility transport of critically ill or critically injured pediatric patient, 24
months of age or less; first 30-74 minutes of hands on care during transport
99290 Critical care services delivered by a physician, face-to-face, during an 30-Sep-08 14-Oct-12
months of age or less; each additional 30 minutes (List separately in addition to
code for prima
99291 Critical care, evaluation and management of the critically ill or critically injured 30-Sep-08 1
patient; first 30-74 minutes
99292 Critical care, evaluation and management of the critically ill or critically injured 30-Sep-08
patient; each additional 30 minutes (List separately in addition to code for
primary service)
99293 Initial inpatient pediatric critical care, per day, for the evaluation and 30-Sep-08 14-Oct-12
management of a critically ill infant or young child, 29 days through 24 months
of age
99294 Subsequent inpatient pediatric critical care, per day, for the evaluation and 30-Sep-08 14-Oct-12
of age
99295 Initial inpatient neonatal critical care, per day, for the evaluation and 30-Sep-08 14-Oct-12
management of a critically ill neonate, 28 days of age or less
99296 Subsequent inpatient neonatal critical care, per day, for the evaluation and 30-Sep-08 14-Oct-12
management of a critically ill neonate, 28 days of age or less
99298 Subsequent intensive care, per day, for the evaluation and management of the 30-Sep-08 14-Oct-12
recovering very low birth weight infant (present body weight less than 1500 g)
recovering low birth weight infant (present body weight of 1500-2500 g)
recovering infant (present body weight of 2501-5000 g)
99304 Initial nursing facility care, per day, for the evaluation and management of a 30-Sep-08 1
patient, which requires these 3 key components: A detailed or comprehensive
history; A detailed or comprehensive examination; and Medical decision making
that is straightforward or of low complexity. Counseling and/or coordination of
the problem(s) and the patient's and/or family's needs. Usually, the problem(s)
requiring admission are of low severity. Physicians typically spend 25 minutes at
the bedside and on the patient's facility floor or unit.
patient's and/or family's needs. Usually, the problem(s) requiring admission are
of moderate severity. Physicians typically spend 35 minutes at the bedside and
on the patient's facility floor or unit.
family's needs. Usually, the problem(s) requiring admission are of high severity.
Physicians typically spend 45 minutes at the bedside and on the patient's facility
floor or unit.
99307 Subsequent nursing facility care, per day, for the evaluation and management of 30-Sep-08 1
a patient, which requires at least 2 of these 3 key components: A problem
focused interval history; A problem focused examination; Straightforward
medical decision making. Counseling and/or coordination of care with other
and the patient's and/or family's needs. Usually, the patient is stable,
and on the patient's facility floor or unit.
a patient, which requires at least 2 of these 3 key components: An expanded
Medical decision making of low complexity. Counseling and/or coordination of
the problem(s) and the patient's and/or family's needs. Usually, the patient is
floor or unit.
a patient, which requires at least 2 of these 3 key components: A detailed
interval history; A detailed examination; Medical decision making of moderate
patient's and/or family's needs. Usually, the patient has developed a significant
at the bedside and on the patient's facility floor or unit.
a patient, which requires at least 2 of these 3 key components: A comprehensive
interval history; A comprehensive examination; Medical decision making of high
patient's and/or family's needs. The patient may be unstable or may have
developed a significant new problem requiring immediate physician attention.
floor or unit.
99315 Nursing facility discharge day management; 30 minutes or less 30-Sep-08

99316 Nursing facility discharge day management; more than 30 minutes 30-Sep-08
99318 Evaluation and management of a patient involving an annual nursing facility 30-Sep-08 1
assessment, which requires these 3 key components: A detailed interval history;
A comprehensive examination; and Medical decision making that is of low to
and the patient's and/or family's needs. Usually, the patient is stable,
and on the patient's facility floor or unit.
99324 Domiciliary or rest home visit for the evaluation and management of a new 30-Sep-08 1
patient, which requires these 3 key components: A problem focused history; A
problem focused examination; and Straightforward medical decision making.
family's needs. Usually, the presenting problem(s) are of low severity. Physicians
typically spend 20 minutes with the patient and/or family or caregiver.
patient, which requires these 3 key components: An expanded problem focused
history; An expanded problem focused examination; and Medical decision
of moderate severity. Physicians typically spend 30 minutes with the patient
and/or family or caregiver.
patient, which requires these 3 key components: A detailed history; A detailed
needs. Usually, the presenting problem(s) are of moderate to high severity.
Physicians typically spend 45 minutes with the patient and/or family or
caregiver.
patient's and/or family's needs. Usually, the presenting problem(s) are of high
severity. Physicians typically spend 60 minutes with the patient and/or family or
caregiver.
new problem requiring immediate physician attention. Physicians typically spend
75 minutes with the patient and/or family or caregiver.
99334 Domiciliary or rest home visit for the evaluation and management of an 30-Sep-08 1
problem focused interval history; A problem focused examination;
Straightforward medical decision making. Counseling and/or coordination of care
problem(s) are self-limited or minor. Physicians typically spend 15 minutes with
the patient and/or family or caregiver.
established patient, which requires at least 2 of these 3 key components: An
expanded problem focused interval history; An expanded problem focused
examination; Medical decision making of low complexity. Counseling and/or
Usually, the presenting problem(s) are of low to moderate severity. Physicians
typically spend 25 minutes with the patient and/or family or caregiver.
detailed interval history; A detailed examination; Medical decision making of
of moderate to high severity. Physicians typically spend 40 minutes with the
patient and/or family or caregiver.
comprehensive interval history; A comprehensive examination; Medical decision
making of moderate to high complexity. Counseling and/or coordination of care
problem(s) are of moderate to high severity. The patient may be unstable or may
have developed a significant new problem requiring immediate physician
attention. Physicians typically spend 60 minutes with the patient and/or family
or caregiver.
99339 Individual physician supervision of a patient (patient not present) in home, 30-Sep-08
domiciliary or rest home (eg, assisted living facility) requiring complex and
multidisciplinary care modalities involving regular physician development and/or
revision of care plans, review of subsequent reports of patient status, review of
related laboratory and other studies, communication (including telephone calls)
for purposes of assessment or care decisions with health care professional(s),
family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key
caregiver(s) involved in patient's care, integration of new information into the
medical treatment plan and/or adjustment of medical therapy, within a calendar
month; 15-29 minutes
99340 Individual physician supervision of a patient (patient not present) in home, 30-Sep-08
domiciliary or rest home (eg, assisted living facility) requiring complex and
multidisciplinary care modalities involving regular physician development and/or
revision of care plans, review of subsequent reports of patient status, review of
related laboratory and other studies, communication (including telephone calls)
for purposes of assessment or care decisions with health care professional(s),
family member(s), surrogate decision maker(s) (eg, legal guardian) and/or key
caregiver(s) involved in patient's care, integration of new information into the
medical treatment plan and/or adjustment of medical therapy, within a calendar
month; 30 minutes or more
99341 Home visit for the evaluation and management of a new patient, which requires 30-Sep-08 1
these 3 key components: A problem focused history; A problem focused
examination; and Straightforward medical decision making. Counseling and/or
Usually, the presenting problem(s) are of low severity. Physicians typically spend
20 minutes face-to-face with the patient and/or family.
these 3 key components: An expanded problem focused history; An expanded
problem focused examination; and Medical decision making of low complexity.
family's needs. Usually, the presenting problem(s) are of moderate severity.
these 3 key components: A detailed history; A detailed examination; and Medical
decision making of moderate complexity. Counseling and/or coordination of care
needs. Usually, the presenting problem(s) are of high severity. Physicians
examination; and Medical decision making of high complexity. Counseling and/or
Usually, the patient is unstable or has developed a significant new problem
requiring immediate physician attention. Physicians typically spend 75 minutes
face-to-face with the patient and/or family.
99347 Home visit for the evaluation and management of an established patient, which 30-Sep-08 1
requires at least 2 of these 3 key components: A problem focused interval
history; A problem focused examination; Straightforward medical decision
making. Counseling and/or coordination of care with other providers or agencies
are provided consistent with the nature of the problem(s) and the patient's
and/or family's needs. Usually, the presenting problem(s) are self limited or
minor. Physicians typically spend 15 minutes face-to-face with the patient and/or
family.
requires at least 2 of these 3 key components: An expanded problem focused
interval history; An expanded problem focused examination; Medical decision
of low to moderate severity. Physicians typically spend 25 minutes face-to-face
requires at least 2 of these 3 key components: A detailed interval history; A
detailed examination; Medical decision making of moderate complexity.
family's needs. Usually, the presenting problem(s) are moderate to high severity.
requires at least 2 of these 3 key components: A comprehensive interval history;
A comprehensive examination; Medical decision making of moderate to high
moderate to high severity. The patient may be unstable or may have developed
a significant new problem requiring immediate physician attention. Physicians
99354 Prolonged physician service in the office or other outpatient setting requiring 30-Sep-08 1
direct (face-to-face) patient contact beyond the usual service; first hour (List
separately in addition to code for office or other outpatient Evaluation and
Management service)
99355 Prolonged physician service in the office or other outpatient setting requiring 30-Sep-08
direct (face-to-face) patient contact beyond the usual service; each additional 30
minutes (List separately in addition to code for prolonged physician service)
99356 Prolonged physician service in the inpatient setting, requiring unit/floor time 30-Sep-08 1
beyond the usual service; first hour (List separately in addition to code for
inpatient Evaluation and Management service)
99357 Prolonged physician service in the inpatient setting, requiring unit/floor time 30-Sep-08
beyond the usual service; each additional 30 minutes (List separately in addition
to code for prolonged physician service)
99358 Prolonged evaluation and management service before and/or after direct (face- 30-Sep-08
to-face) patient care; first hour
99359 Prolonged evaluation and management service before and/or after direct (face- 30-Sep-08
to-face) patient care; each additional 30 minutes (List separately in addition to
code for prolonged physician service)
99360 Physician standby service, requiring prolonged physician attendance, each 30 30-Sep-08
minutes (eg, operative standby, standby for frozen section, for cesarean/high
risk delivery, for monitoring EEG)
99363 Anticoagulant management for an outpatient taking warfarin, physician review 30-Sep-08
and interpretation of International Normalized Ratio (INR) testing, patient
instructions, dosage adjustment (as needed), and ordering of additional tests;
initial 90 days of therapy (must include a minimum of 8 INR measurements)
99364 Anticoagulant management for an outpatient taking warfarin, physician review 30-Sep-08
and interpretation of International Normalized Ratio (INR) testing, patient
instructions, dosage adjustment (as needed), and ordering of additional tests;
each subsequent 90 days of therapy (must include a minimum of 3 INR
measurements)
99366 Medical team conference with interdisciplinary team of health care professionals, 30-Sep-08
face-to-face with patient and/or family, 30 minutes or more, participation by
nonphysician qualified health care professional
patient and/or family not present, 30 minutes or more; participation by physician
patient and/or family not present, 30 minutes or more; participation by
nonphysician qualified health care professional
99374 Physician supervision of a patient under care of home health agency (patient not 30-Sep-08
present) in home, domiciliary or equivalent environment (eg, Alzheimer's
facility) requiring complex and multidisciplinary care modalities involving regular
physician development and/or revision of care plans, review of subsequent
reports of patient status, review of related laboratory and other studies,
communication (including telephone calls) for purposes of assessment or care
decisions with health care professional(s), family member(s), surrogate decision
maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care,
integration of new information into the medical treatment plan and/or
adjustment of medical therapy, within a calendar month; 15-29 minutes
99375 Physician supervision of a patient under care of home health agency (patient not 30-Sep-08
present) in home, domiciliary or equivalent environment (eg, Alzheimer's
facility) requiring complex and multidisciplinary care modalities involving regular
physician development and/or revision of care plans, review of subsequent
reports of patient status, review of related laboratory and other studies,
communication (including telephone calls) for purposes of assessment or care
decisions with health care professional(s), family member(s), surrogate decision
maker(s) (eg, legal guardian) and/or key caregiver(s) involved in patient's care,
integration of new information into the medical treatment plan and/or
adjustment of medical therapy, within a calendar month; 30 minutes or more
99377 Physician supervision of a hospice patient (patient not present) requiring 30-Sep-08
complex and multidisciplinary care modalities involving regular physician
development and/or revision of care plans, review of subsequent reports of
patient status, review of related laboratory and other studies, communication
(including telephone calls) for purposes of assessment or care decisions with
health care professional(s), family member(s), surrogate decision maker(s) (eg,
legal guardian) and/or key caregiver(s) involved in patient's care, integration of
new information into the medical treatment plan and/or adjustment of medical
therapy, within a calendar month; 15-29 minutes
99378 Physician supervision of a hospice patient (patient not present) requiring 30-Sep-08
therapy, within a calendar month; 30 minutes or more
99379 Physician supervision of a nursing facility patient (patient not present) requiring 30-Sep-08
therapy, within a calendar month; 15-29 minutes
99380 Physician supervision of a nursing facility patient (patient not present) requiring 30-Sep-08
therapy, within a calendar month; 30 minutes or more
99381 Initial comprehensive preventive medicine evaluation and management of an 30-Sep-08

individual including an age and gender appropriate history, examination,
counseling/anticipatory guidance/risk factor reduction interventions, and the
ordering of laboratory/diagnostic procedures, new patient; infant (age younger
than 1 year)

ordering of laboratory/diagnostic procedures, new patient; early childhood (age
1 through 4 years)
ordering of laboratory/diagnostic procedures, new patient; late childhood (age 5
through 11 years)

ordering of laboratory/diagnostic procedures, new patient; adolescent (age 12
through 17 years)

ordering of laboratory/diagnostic procedures, new patient; 18-39 years

ordering of laboratory/diagnostic procedures, new patient; 40-64 years

ordering of laboratory/diagnostic procedures, new patient; 65 years and older
99391 Periodic comprehensive preventive medicine reevaluation and management of 30-Sep-08

an individual including an age and gender appropriate history, examination,
ordering of laboratory/diagnostic procedures, established patient; infant (age
younger than 1 year)

ordering of laboratory/diagnostic procedures, established patient; early
childhood (age 1 through 4 years)

ordering of laboratory/diagnostic procedures, established patient; late childhood
(age 5 through 11 years)

ordering of laboratory/diagnostic procedures, established patient; adolescent
(age 12 through 17 years)

ordering of laboratory/diagnostic procedures, established patient; 18-39 years

ordering of laboratory/diagnostic procedures, established patient; 40-64 years

ordering of laboratory/diagnostic procedures, established patient; 65 years and
older
99401 Preventive medicine counseling and/or risk factor reduction intervention(s) 30-Sep-08
provided to an individual (separate procedure); approximately 15 minutes
99406 Smoking and tobacco use cessation counseling visit; intermediate, greater than 30-Sep-08 1
3 minutes up to 10 minutes
99407 Smoking and tobacco use cessation counseling visit; intensive, greater than 10 30-Sep-08 1
minutes
99408 Alcohol and/or substance (other than tobacco) abuse structured screening (eg, 30-Sep-08
AUDIT, DAST), and brief intervention (SBI) services; 15 to 30 minutes
99409 Alcohol and/or substance (other than tobacco) abuse structured screening (eg, 30-Sep-08
AUDIT, DAST), and brief intervention (SBI) services; greater than 30 minutes
provided to individuals in a group setting (separate procedure); approximately
30 minutes
provided to individuals in a group setting (separate procedure); approximately
60 minutes
99420 Administration and interpretation of health risk assessment instrument (eg, 30-Sep-08
health hazard appraisal)
99429 Unlisted preventive medicine service 30-Sep-08
99431 History and examination of the normal newborn infant, initiation of diagnostic 30-Sep-08 14-Oct-12
and treatment programs and preparation of hospital records. (This code should
also be used for birthing room deliveries.)
99432 Normal newborn care in other than hospital or birthing room setting, including 30-Sep-08 14-Oct-12
physical examination of baby and conference(s) with parent(s)
99433 Subsequent hospital care, for the evaluation and management of a normal 30-Sep-08 14-Oct-12
newborn, per day
99435 History and examination of the normal newborn infant, including the preparation 30-Sep-08 14-Oct-12
of medical records. (This code should only be used for newborns assessed and
discharged from the hospital or birthing room on the same date.)
99436 Attendance at delivery (when requested by delivering physician) and initial 30-Sep-08 14-Oct-12
stabilization of newborn
99440 Newborn resuscitation: provision of positive pressure ventilation and/or chest 30-Sep-08 14-Oct-12
compressions in the presence of acute inadequate ventilation and/or cardiac
output
99441 Telephone evaluation and management service provided by a physician to an 30-Sep-08
established patient, parent, or guardian not originating from a related E/M
service provided within the previous 7 days nor leading to an E/M service or
procedure within the next 24 hours or soonest available appointment; 5-10
minutes of medical discussion


99444 Online evaluation and management service provided by a physician to an 30-Sep-08
established patient, guardian, or health care provider not originating from a
related E/M service provided within the previous 7 days, using the Internet or
similar electronic communications network
99450 Basic life and/or disability examination that includes: Measurement of height, 30-Sep-08
weight, and blood pressure; Completion of a medical history following a life
insurance pro forma; Collection of blood sample and/or urinalysis complying with
"chain of custody" protocols; and Completion of necessary
documentation/certificates.
99455 Work related or medical disability examination by the treating physician that 30-Sep-08 1
includes: Completion of a medical history commensurate with the patient's
condition; Performance of an examination commensurate with the patient's
condition; Formulation of a diagnosis, assessment of capabilities and stability,
and calculation of impairment; Development of future medical treatment plan;
and Completion of necessary documentation/certificates and report.
99456 Work related or medical disability examination by other than the treating 30-Sep-08 1
physician that includes: Completion of a medical history commensurate with the
patient's condition; Performance of an examination commensurate with the
patient's condition; Formulation of a diagnosis, assessment of capabilities and
stability, and calculation of impairment; Development of future medical
treatment plan; and Completion of necessary documentation/certificates and
report.
99460 Initial hospital or birthing center care, per day, for evaluation and management 15-Oct-12 1
of normal newborn infant
99461 Initial care, per day, for evaluation and management of normal newborn infant 15-Oct-12 1
seen in other than hospital or birthing center
99462 Subsequent hospital care, per day, for evaluation and management of normal 15-Oct-12 1
newborn
99463 Initial hospital or birthing center care, per day, for evaluation and management 15-Oct-12 1
of normal newborn infant admitted and discharged on the same date
99464 Attendance at delivery (when requested by the delivering physician) and initial 15-Oct-12 1
stabilization of newborn
99465 Delivery/birthing room resuscitation, provision of positive pressure ventilation 15-Oct-12 1
and/or chest compressions in the presence of acute inadequate ventilation
and/or cardiac output
99466 Critical care services delivered by a physician, face-to-face, during an 15-Oct-12 1
months of age or younger; first 30-74 minutes of hands-on care during transport
99467 Critical care services delivered by a physician, face-to-face, during an 15-Oct-12

months of age or younger; each additional 30 minutes (List separately in
addition to code for primary service)
99468 Initial inpatient neonatal critical care, per day, for the evaluation and 15-Oct-12 1
management of a critically ill neonate, 28 days of age or younger
99469 Subsequent inpatient neonatal critical care, per day, for the evaluation and 15-Oct-12 1
management of a critically ill neonate, 28 days of age or younger
99471 Initial inpatient pediatric critical care, per day, for the evaluation and 15-Oct-12 1
of age
99472 Subsequent inpatient pediatric critical care, per day, for the evaluation and 15-Oct-12 1
of age
99475 Initial inpatient pediatric critical care, per day, for the evaluation and 15-Oct-12
management of a critically ill infant or young child, 2 through 5 years of age
99476 Subsequent inpatient pediatric critical care, per day, for the evaluation and 15-Oct-12
management of a critically ill infant or young child, 2 through 5 years of age
99477 Initial hospital care, per day, for the evaluation and management of the neonate, 30-Sep-08 1
28 days of age or younger, who requires intensive observation, frequent
interventions, and other intensive care services
99478 Subsequent intensive care, per day, for the evaluation and management of the 15-Oct-12 1
recovering very low birth weight infant (present body weight less than 1500
grams)
recovering low birth weight infant (present body weight of 1500-2500 grams)
recovering infant (present body weight of 2501-5000 grams)
99499 Unlisted evaluation and management service 30-Sep-08
99500 Home visit for prenatal monitoring and assessment to include fetal heart rate, 30-Sep-08
non-stress test, uterine monitoring, and gestational diabetes monitoring
99501 Home visit for postnatal assessment and follow-up care 30-Sep-08
99502 Home visit for newborn care and assessment 30-Sep-08
99503 Home visit for respiratory therapy care (eg, bronchodilator, oxygen therapy, 30-Sep-08
respiratory assessment, apnea evaluation)
99504 Home visit for mechanical ventilation care 30-Sep-08
99505 Home visit for stoma care and maintenance including colostomy and cystostomy 30-Sep-08
99506 Home visit for intramuscular injections 30-Sep-08
99507 Home visit for care and maintenance of catheter(s) (eg, urinary, drainage, and 30-Sep-08
enteral)
99509 Home visit for assistance with activities of daily living and personal care 30-Sep-08
99510 Home visit for individual, family, or marriage counseling 30-Sep-08
99511 Home visit for fecal impaction management and enema administration 30-Sep-08
99512 Home visit for hemodialysis 30-Sep-08
99600 Unlisted home visit service or procedure 30-Sep-08
99601 Home infusion/specialty drug administration, per visit (up to 2 hours); 30-Sep-08
99602 Home infusion/specialty drug administration, per visit (up to 2 hours); each 30-Sep-08
additional hour (List separately in addition to code for primary procedure)
99605 Medication therapy management service(s) provided by a pharmacist, individual, 30-Sep-08 1

face-to-face with patient, with assessment and intervention if provided; initial 15
minutes, new patient
face-to-face with patient, with assessment and intervention if provided; initial 15
minutes, established patient
face-to-face with patient, with assessment and intervention if provided; each
additional 15 minutes (List separately in addition to code for primary service)
P9010 Blood (whole), for transfusion, per unit 30-Sep-08
P9011 Blood, split unit 30-Sep-08
P9012 Cryoprecipitate, each unit 30-Sep-08
P9016 Red blood cells, leukocytes reduced, each unit 30-Sep-08
P9017 Fresh frozen plasma (single donor), frozen within 8 hours of collection, each unit 30-Sep-08
P9019 Platelets, each unit 30-Sep-08
P9020 Platelet rich plasma, each unit 30-Sep-08
P9021 Red blood cells, each unit 30-Sep-08
P9022 Red blood cells, washed, each unit 30-Sep-08
P9023 Plasma, pooled multiple donor, solvent/detergent treated, frozen, each unit 30-Sep-08
P9031 Platelets, leukocytes reduced, each unit 30-Sep-08
P9032 Platelets, irradiated, each unit 30-Sep-08
P9033 Platelets, leukocytes reduced, irradiated, each unit 30-Sep-08
P9034 Platelets, pheresis, each unit 30-Sep-08
P9035 Platelets, pheresis, leukocytes reduced, each unit 30-Sep-08
P9036 Platelets, pheresis, irradiated, each unit 30-Sep-08
P9037 Platelets, pheresis, leukocytes reduced, irradiated, each unit 30-Sep-08
P9038 Red blood cells, irradiated, each unit 30-Sep-08
P9039 Red blood cells, deglycerolized, each unit 30-Sep-08
P9040 Red blood cells, leukocytes reduced, irradiated, each unit 30-Sep-08
P9041 Infusion, albumin (human), 5%, 50 ml 30-Sep-08

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Code Code Description CPT Code CPT Code CPT

Effective Expiry MUE Values

0030T Antiprothrombin (phospholipid cofactor) antibody, each Ig class 30-Sep-08 2

0054T Computer-assisted musculoskeletal surgical navigational orthopedic procedure, 15-Oct-12 2

0073T Compensator-based beam modulation treatment delivery of inverse planned 30-Sep-08 2

0075T Transcatheter placement of extracranial vertebral or intrathoracic carotid artery 30-Sep-08 1

0087T Sperm evaluation, Hyaluronan sperm binding test 30-Sep-08 14-Oct-12

0103T Holotranscobalamin, quantitative 30-Sep-08 1

0123T Fistulization of sclera for glaucoma, through ciliary body 30-Sep-08 2

0200T Percutaneous sacral augmentation (sacroplasty), unilateral injection(s), including 15-Oct-12

0201T Percutaneous sacral augmentation (sacroplasty), bilateral injections, including 15-Oct-12

0206T Algorithmic analysis, remote, of electrocardiographic-derived data with computer 15-Oct-12

0237T Transluminal peripheral atherectomy, open or percutaneous, including 15-Oct-12 2

0240T Esophageal motility (manometric study of the esophagus and/or 15-Oct-12 1

0256T Implantation of catheter-delivered prosthetic aortic heart valve; endovascular 15-Oct-12 1

10021 Fine needle aspiration; without imaging guidance 30-Sep-08

10140 Incision and drainage of hematoma, seroma or fluid collection 30-Sep-08

11040 Debridement; skin, partial thickness 30-Sep-08 14-Oct-12

11950 Subcutaneous injection of filling material (eg, collagen); 1 cc or less 30-Sep-08 1

11976 Removal, implantable contraceptive capsules 30-Sep-08 1

11977 Removal with reinsertion, implantable contraceptive capsules 30-Sep-08

14000 Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less 30-Sep-08

15340 Tissue cultured allogeneic skin substitute; first 25 sq cm or less 30-Sep-08 1

15786 Abrasion; single lesion (eg, keratosis, scar) 30-Sep-08 1

15822 Blepharoplasty, upper eyelid; 30-Sep-08 1

15824 Rhytidectomy; forehead 30-Sep-08 1

15826 Rhytidectomy; glabellar frown lines 30-Sep-08 1

15828 Rhytidectomy; cheek, chin, and neck 30-Sep-08 1

15829 Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap 30-Sep-08 1

15877 Suction assisted lipectomy; trunk 30-Sep-08 1

15878 Suction assisted lipectomy; upper extremity 30-Sep-08 2

15879 Suction assisted lipectomy; lower extremity 30-Sep-08 2

15931 Excision, sacral pressure ulcer, with primary suture; 30-Sep-08 1

16035 Escharotomy; initial incision 30-Sep-08 1

17004 Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, 30-Sep-08 1

17340 Cryotherapy (CO2 slush, liquid N2) for acne 30-Sep-08 1

19000 Puncture aspiration of cyst of breast; 30-Sep-08 2

19260 Excision of chest wall tumor including ribs 30-Sep-08 2

19296 Placement of radiotherapy afterloading expandable catheter (single or 30-Sep-08 2

19298 Placement of radiotherapy afterloading brachytherapy catheters (multiple tube 30-Sep-08 2

19316 Mastopexy 30-Sep-08 1

19324 Mammaplasty, augmentation; without prosthetic implant 30-Sep-08 1

19325 Mammaplasty, augmentation; with prosthetic implant 30-Sep-08 1

19328 Removal of intact mammary implant 30-Sep-08 1

19355 Correction of inverted nipples 30-Sep-08 1

19370 Open periprosthetic capsulotomy, breast 30-Sep-08 1

20103 Exploration of penetrating wound (separate procedure); extremity 30-Sep-08 4

20551 Injection(s); single tendon origin/insertion 30-Sep-08

20665 Removal of tongs or halo applied by another physician 30-Sep-08 1

20838 Replantation, foot, complete amputation 30-Sep-08 2

20985 Computer-assisted surgical navigational procedure for musculoskeletal 30-Sep-08 2

20999 Unlisted procedure, musculoskeletal system, general 30-Sep-08

21010 Arthrotomy, temporomandibular joint 30-Sep-08 1

21044 Excision of malignant tumor of mandible; 30-Sep-08 1

21050 Condylectomy, temporomandibular joint (separate procedure) 30-Sep-08 1

21076 Impression and custom preparation; surgical obturator prosthesis 30-Sep-08 1

21089 Unlisted maxillofacial prosthetic procedure 30-Sep-08

21240 Arthroplasty, temporomandibular joint, with or without autograft (includes 30-Sep-08 2