Top Mobile Menu Bottom Mobile Menu

Search For:

June 08, 2022, 09:18 EDT

Chapter : Appendix B Mandatory Outpatient Surgical List (PP)

Updated: 8/1/1992

Integumentary System

Incision and Drainage

 

CPT

Codes        Description

10081         Incision and drainage of pilonidal cyst; complicated

10121            Incision and removal of  foreign  body, subcutaneous tissues; complicated

10140

Incision and drainage of hematoma, seroma, or fluid collection

10160

Puncture aspiration of abscess, hematoma, bulla, or cyst

11040

Debridement; skin, partial thickness

 

Excision-Benign Lesion(s)

11400

Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms, or legs; lesion diameter 0.5 cm or less

11401

lesion diameter 0.6 to 1.0 cm

11402

lesion diameter 1.1 to 2.0 cm

11403

lesion diameter 2.1 to 3.0 cm

11404

lesion diameter 3.1 to 4.0 cm

11406

lesion diameter over 4.0 cm

11420

Excision, benign lesion, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less

11421

lesion diameter 0.6 to 1.0 cm

11422

lesion diameter 1.1 to 2.0 cm

11423

lesion diameter 2.1 to 3.0 cm

11424

lesion diameter 3.1 to 4.0 cm

11426

lesion diameter over 4.0 cm

 

11440

Excision, other benign lesion (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; lesion 0.5 cm or less

11441

lesion diameter 0.6 to 1.0 cm

11442

lesion diameter 1.1 to 2.0 cm

11443

lesion diameter 2.1 to 3.0 cm

11444

lesion diameter 3.1 to 4.0 cm

11446

lesion diameter over 4.0 cm

 

Excision-Malignant Lesion(s)

11600

Excision, malignant lesion, trunk, arms, or legs; lesion diameter 1.5 cm or less

11601

lesion diameter 0.6 to 1.0 cm

11602

lesion diameter 1.1 to 2.0 cm

11603

lesion diameter 2.1 to 3.0 cm

11604

lesion diameter 3.1 to 4.0 cm

11606

lesion diameter over 4.0 cm

11620

Excision, malignant lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less

11621

lesion diameter 0.6 to 1.0 cm

11622

lesion diameter 1.1 to 2.0 cm

11623

lesion diameter 2.1 to 3.0 cm

11624

lesion diameter 3.1 to 4.0 cm

11626

lesion diameter over 4.0 cm

11640

Excision, malignant lesion, face, ears, eyelids, nose, lips; lesion diameter 0.5 cm or less

11641

lesion diameter 0.6 to 1.0 cm

11642

lesion diameter 1.1 to 2.0 cm

 

     11643                  lesion diameter 2.1 to 3.0 cm

11644                  lesion diameter 3.1 to 4.0 cm

11646                  lesion diameter over 4.0 cm

 

Nails

11730         Avulsion of nail plate, partial or complete, simple; single

11731              second nail plate

11732              each additional nail plate

11740         Evacuation of subungual hematoma

11750         Excision of nail and nail matrix, partial or complete, (e.g., ingrown or deformed nail) for permanent removal;

11752              with amputation of tuft of distal phalanx

11755         Biopsy of nail unit, any method (e.g., plate, bed, matrix, hyponychium, proximal and lateral nail fold) (separate procedure)

11760         Repair of nail bed

11762         Reconstruction of nail bed with graft

11765         Wedge resection of skin of nail fold (e.g., for ingrown toenail)

11770         Excision of pilonidal cyst or sinus; simple

Introduction

 

11950         Subcutaneous injection of “filling” material (e.g. collagen); 1 cc or less

11951              1.1 to 5.0 cc

 

Repair-Simple

12020         Treatment of superficial wound dehiscence; simple closure

 

Free Skin Grafts

 

15050    Pinch graft, single of multiple, to cover small ulcer, tip of  digit, or     other minimal open area (except on face), up to defect size 2 cm diameter

 

Other Procedures

 

15820

Blepharoplasty, lower eyelid;

15822

Blepharoplasty. upper eyelid;

15850

Removal of sutures under anesthesia (other than local), same surgeon

15851

Removal of sutures under anesthesia (other than local), other surgeon

15852

Dressing change (for other than burns) under anesthesia (other than local)

 

Burns, Local Treatment

 

16000       Initial treatment, first degree burn, when no more than local treatment  is required

16010  Dressing and/or debridement, initial or subsequent; under anesthesia,  small

16020              without anesthesia, office or hospital, small

16025              without anesthesia, medium (e.g., whole face or whole extremity)

16030              without anesthesia, large (e.g., more than one extremity)

 

Breast

Incision

19000         Puncture aspiration of cyst of breast;

19001              each additional cyst

19020         Mastotomy with exploration or drainage of abscess, deep

19030         Injection procedure only for mammary ductogram or galactogram

Excision

 

19100         Biopsy of breast; needle core

19101              incisional

19110    Nipple exploration, with or without excision of  a solitary lactiferous   duct or a papilloma lactiferous duct

19112         Excision of lactiferous duct fistula

19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor aberrant breast tissue, duct lesion or nipple lesion (except 19140), male or female, one or more lesions

19125 Excision of breast lesion identified by preoperative placement of radiological marker; single lesion

19126              each additional lesion separately identified by a radiological marker

19140         Mastectomy for gynecomastia

 

Introduction

19290         Preoperative placement of needle localization wire, breast;

19291              each additional lesion

 

Repair and/or Reconstruction

 

19328

Removal of intact mammary implant

19330

Removal of mammary implant material

19396

Preparation of moulage for custom breast implant

 

Musculoskeletal System

Biopsy

20205         Biopsy, muscle, deep

20220

Biopsy, bone, trocar or needle; superficial (e.g., ilium, sternum, spinous process, ribs)

20240

Biopsy, excisional; superficial (e.g., ilium, sternum, spinous process, ribs, trochanter of femur)

 

Introduction or Removal

20501              Injection of sinus tract; diagnostic (sinogram)

20520         Removal of foreign body in muscle or tendon sheath; simple

20525              deep or complicated

20600         Arthrocentesis, aspiration and/or injection; small joint, bursa or ganglion cyst (e.g.. fingers, toes)

20605              intermediate joint, bursa, or ganglion cyst (e.g., temporomandibular, acromioclavicular, wrist, elbow, or ankle, olecranon bursa)

 

20610

major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa)

20615

Aspiration and injection for treatment of bone cyst

20665

Removal of tongs or halo applied by another physician

20670

Removal of implant; superficial, (e.g., buried wire, pin or rod)

20693

Adjustment   or   revision   of   external   fixation                    system           requiring anesthesia (e.g., new pin(s) or wire(s) and/or new ring(s) or bar(s))

20694

Removal, under anesthesia, of external fixation system

 

Other Procedures

20974         Electrical stimulation to aid bone healing; noninvasive (nonoperative)

 

Head Incision

21010         Arthrotomy, temporomandibular joint

 

 

 

 

 

 

Excision

21040         Excision of benign cyst or tumor of mandible; simple

Introduction or Removal

21116         Injection procedure for temporomandibular joint arthrography

 

Repair, Revision, and/or Reconstruction 21280         Medial canthopexy

21282         Lateral canthopexy

 

Fracture and/or Dislocation

 

21310

Closed treatment of nasal bone fracture without manipulation

21315

Closed treatment of nasal bone fracture without stabilization

21320

with stabilization

21325

Open treatment of nasal fracture; uncomplicated

21337

Closed treatment of nasal septal fracture, with or without stabilization

21440

Closed treatment of mandibular or maxillary alveolar ridge fracture

21450

Closed treatment of mandibular fracture; without manipulation

21451

with manipulation

21452

Percutaneous treatment of mandibular fracture, with external fixation

21453

Closed treatment of mandibular fracture with interdental fixation

21480

Closed   treatment   of   temporomandibular             dislocation;      initial                        or subsequent

21485

complicated (e.g., recurrent requiring intermaxillary fixation or splinting), initial or subsequent

 

 

 

 

 

 

Neck

Repair, Revision, and/or Reconstruction

21700         Division of scalenus anticus; without resection of cervical rib

 

Fracture and/or Dislocation

21800         Closed treatment of rib fracture, uncomplicated, each

Back and Flank Excision

21930         Excision, tumor, soft tissue of back or flank

 

Spine (Vertebral Column) Manipulation

22505         Manipulation of spine requiring anesthesia, any region

Abdomen

22900         Excision, abdominal wall tumor, subfascial (e.g., desmoid)

Shoulder Incision

23000         Removal of subdeltoid (or intratendinous) calcareous deposits, open method

23020         Capsular contracture release (Sever type procedure)

23030         Incision and drainage, shoulder area; deep abscess or hematoma

 

23040

Arthrotomy, glenohumeral joint, for infection, with exploration, drainage or removal of foreign body

23044

Arthotomy, acromioclavicular, sternoclavicular joint, for infection, with exploration, drainage or removal of foreign body

 

 

 

 

 

 

Excision

23100         Arthrotomy with biopsy, glenohumeral joint

23101         Arthrotomy   with   biopsy,   or   with   excision   of   torn cartilage, acromioclavicular, sternoclavicular joint

23105         Arthrotomy with synovectomy; glenohumeral joint

23106              sternoclavicular joint

23107         Arthrotomy, glenohumeral joint, with joint exploration, with or without removal of loose or foreign body

 

Introduction or Removal

23350         Injection procedure for shoulder arthrography

Fracture and/or Dislocation

23500         Closed treatment of clavicular fracture; without manipulation

23505              with manipulation

23520         Closed treatment of sternoclavicular dislocation; without manipulation

23525              with manipulation

23540         Closed    treatment    of     acromioclavicular               dislocation; without manipulation

 

23545

with manipulation

23570

Closed treatment of scapular fracture; without manipulation

23600

Closed treatment of proximal humeral (surgical or anatomical neck) fracture; without manipulation

23605

with manipulation, with or without skeletal traction

23650

Closed treatment of shoulder dislocation, with manipulation; without anesthesia

23655

requiring anesthesia

 

 

 

 

 

 

Humerus (Upper Arm) and Elbow Incision

23930         Incision and drainage, upper arm or elbow area; deep abscess or hematoma

24000         Arthrotomy, elbow, for infection, with exploration, drainage or removal of foreign body

24006         Arthrotomy of the elbow, with capsular excision for capsular release

 

Excision

24100         Arthrotomy, elbow, with synovial biopsy only

24101              with joint exploration, with or without biopsy, with or without removal of loose or foreign body

24102              with synovectomy

24105         Excision, olecranon bursa

24110         Excision or curettage of bone cyst or benign tumor, humerus;

24120         Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process

 

Introduction or Removal

24160         Implant removal; elbow joint

24164              radial head

24220         Injection procedure for elbow arthrography

Fracture and/or Dislocation

24500         Closed treatment of humeral shaft fracture; without manipulation

24505              with manipulation, with or without skeletal traction

24560         Closed treatment of humeral epicondylar fracture, medial or lateral; without manipulation

 

 

 

 

 

24565

with manipulation

24566

Percutaneous skeletal fixation of humeral epicondylar fracture, medial or lateral, with manipulation

24576

Closed treatment of humeral condylar fracture, medial or lateral; without manipulation

24577

with manipulation

24582

Percutaneous skeletal fixation of humeral condylar fracture, medial or lateral, with manipulation

24600

Treatment of closed elbow dislocation; without anesthesia

24605

requiring anesthesia

24640

Closed treatment of radial head subluxation in child, “nursemaid elbow”, with manipulation

24650

Closed treatment of radial head or neck fracture; without manipulation

24655

with manipulation

24670

Closed treatment of ulnar fracture, proximal end (olecranon process); without manipulation

24675

with manipulation

 

Forearm and Wrist Incision

25000         Tendon sheath incision; at radial styloid (e.g., for deQuervain’s disease)

25028         Incision   and   drainage,   forearm   and/or               wrist;                deep       abscess or hematoma

25040         Arthrotomy, radiocarpal or midcarpal joint, with exploration, drainage, or removal of foreign body

 

Excision

25085         Capsulotomy, wrist (e.g., for contracture)

 

 

 

 

25100

Arthrotomy, wrist joint; with biopsy

25101

with joint exploration, with or without biopsy, with or without removal of loose or foreign body

25105

with synovectomy

25107

Arthrotomy, distal radioulnar joint for repair of triangular cartilage complex

25110

Excision, lesion of tendon sheath, forearm and/or wrist

25111

Excision of ganglion, wrist (dorsal or volar); primary

25112

recurrent

25115

Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors

25116

extensors, with or without transposition of dorsal retinaculum

25120

Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process);

25130

Excision or curettage of bone cyst or benign tumor of carpal bones;

25210

Carpectomy; one bone

25230

Radial styloidectomy

 

Introduction or Removal

25246         Injection procedure for wrist arthrography

25248         Exploration with removal of deep foreign body, forearm or wrist

 

Fracture and/or Dislocation

25500        Closed treatment of radial shaft fracture; without manipulation

25505             with manipulation

25530        Closed treatment of ulnar shaft fracture; without manipulation

25535             with manipulation

 

 

 

 

 

25560

Closed   treatment   of   radial   and   ulnar   shaft             fractures;   without manipulation

25565

with manipulation

25622

Closed treatment of carpal scaphoid (navicular) fracture; without manipulation

25624

with manipulation

25630

Closed treatment of carpal bone fracture (excluding carpal scaphoid (navicular)); without manipulation, each bone

25635

with manipulation, each bone

25650

Closed treatment of ulnar styloid fracture

25660

Closed treatment of radiocarpal or intercarpal dislocation, one or more bones; with manipulation

25675

Closed treatment of distal radioulnar dislocation with manipulation

25680

Closed treatment of trans-scaphoperilunar type of fracture dislocation, with manipulation

25690

Closed treatment of lunate dislocation, with manipulation

 

Hand and Fingers Incision

26040         Fasciotomy,     palmar,     for     Dupuytren’s                       contracture;        closed (subcutaneous)

 

26045

open, partial

26055

Tendon sheath incision (e.g., trigger finger)

26060

Tenotomy, subcutaneous, single, each digit

26070

Arthrotomy, for infection, with exploration, drainage or removal of foreign body; carpometacarpal joint

26075

metacarpophalangeal joint

26080

interphalangeal joint, each

 

 

 

 

 

 

 

Excision

26100         Arthrotomy with synovial biopsy; carpometacarpal joint

26105              metacarpophalangeal joint

26110              interphalangeal joint, each

26121         Fasciectomy, palmar only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft)

26170         Excision of tendon, palm, flexor, single, each

26180         Excision of tendon, finger, flexor

26185         Sesamoidectomy, thumb or finger

26210         Excision or curettage of bone cyst or benign tumor of proximal, middle or distal phalanx of finger

26230         Partial excision (craterization, saucerization, or diaphysectomy) of bone (e.g., for osteomyelitis); metacarpal

26235              proximal or middle phalanx of finger

26236              distal phalanx of finger

26260         Radical resection (ostectomy) for tumor, proximal or middle phalanx of finger

26261              with autograft (includes obtaining graft)

26262         Radical resection (ostectomy) for tumor, distal phalanx of finger

 

Repair, Revision, and/or Reconstruction

 

26350

Flexor tendon repair or advancement, single, not in “no man’s land”; primary or secondary without free graft, each tendon

26356

Flexor tendon repair or advancement, single, in “no man”s land”; primary, each tendon

26357

secondary, each tendon

 

 

 

 

26418

Extensor   tendon   repair,   dorsum   of   finger,                single,   primary or secondary; without free graft, hand or finger

26426

Extensor tendon repair, central slip repair, secondary (boutonniere deformity); using local tissues

26432

Extensor tendon repair, distal insertion (“mallet finger”), closed, splinting with or without percutaneous pinning

26433

Extensor tendon repair, distal insertion (“mallet finger”), open, primary or secondary repair; without graft

26440

Tenolysis, simple, flexor tendon; palm OR finger, single, each tendon

26442

palm AND finger, each tendon

26445

Tenolysis, extensor tendon, dorsum of hand or finger; each tendon

26450

Tenotomy, flexor, single, palm, open, each

26455

Tenotomy, flexor, single, finger, open, each

26460

Tenotomy, extensor, hand or finger, single, open, each

26520

Capsulectomy or capsulotomy for contracture; metacarpophalangeal joint, single, each

26525

interphalangeal joint, single, each

26565

Osteotomy for correction of deformity; metacarpal

26567

phalanx of finger

 

Fracture and/or Dislocation

 

26600

Closed treatment of metacarpal fracture, single; without manipulation, each bone

26605

with manipulation, each bone

26607

Closed treatment of metacarpal fracture, with manipulation, with internal or external fixation, each bone

26608

Percutaneous skeletal fixation of metacarpal fracture, each bone

26641

Closed   treatment   of   carpometacarpal             dislocation,      thumb,                 with manipulation

 

 

 

 

 

26645

Closed treatment of carpomtacarpal dislocation, thumb (Bennett

 

fracture), with manipulation

26650

Percutaneous skeletal fixation of carpometacarpal fracture dislocation,

 

thumb (Bennett fracture), with manipulation, with or without external

 

fixation

26670

Closed treatment of carpometacarpal dislocation, thumb (Bennett

 

fracture), single, with manipulation; without anesthesia

26675

requiring anesthesia

26676

Percutaneous skeletal fixation of carpometacarpal dislocation, other

 

than thumb (Bennett fracture), single, with manipulation

26700

Closed treatment of metacarpophalangeal dislocation, single; without

 

anesthesia

26705

requiring anesthesia

26706

Percutaneous skeletal fixation of metacarpophalangeal dislocation,

 

single, with manipulation

26720

Closed treatment of phalangeal shaft fracture, proximal or middle

 

phalanx, finger or thumb; without manipulation, each

26725

with manipulation, with or without skin or skeleton traction, each

26727

Percutaneous skeletal fixation of unstable phalangeal shaft fracture,

 

proximal or middle phalanx, finger or thumb, with manipulation, each

26740

Closed treatment of articular fracture, involving metacarpophalangeal

 

or interphalangeal joint; without manipulation, each

26742

with manipulation, each

26750

Closed treatment of distal phalangeal fracture, finger or thumb;

 

without manipulation, each

26755

with manipulation, each

26756

Percutaneous skeletal fixation of distal phalangeal fracture, finger or

 

thumb, each

26770

Closed treatment of interphalangeal joint dislocation, single, with

 

manipulation; without anesthesia

 

 

 

26775              requiring anesthesia

26776         Percutaneous skeletal fixation of interphalangeal joint dislocation, single, with manipulation

 

Pelvis and Hip Joint

Including head and neck of femur

Incision

27000         Tenotomy, adductor of hip, subcutaneous, closed 27001                  Tenotomy, adductor of hip, subcutaneous, open 27030                  Arthrotomy, hip, for infection, with drainage

27033         Arthrotomy, hip, with exploration or removal of loose or foreign body

 

Excision

27050         Arthrotomy, with biopsy; sacroiliac joint

27052              hip joint

27054         Arthrotomy with synovectomy, hip joint

Introduction or Removal

27093         Injection procedure for hip arthrography; without anesthesia

27095              with anesthesia

 

Femur (Thigh Region) and Knee Joint Including tibial plateaus.

Incision

 

27301

Incision and drainage of deep abscess, infected bursa, or hematoma, thigh or knee region

27310

Arthrotomy, knee, for infection, with exploration, drainage or removal of foreign body

 

 

 

Excision

27330         Arthrotomy, knee; with synovial biopsy only

27331              with joint exploration, with or without biopsy, with or without removal of loose or foreign bodies

27332         Arthrotomy, knee, with excision of semilunar cartilage (meniscetomy); medial OR lateral

27333              medial AND lateral

27334         Arthrotomy, knee, with synovectomy; anterior OR posterior

27335              anterior AND posterior including popliteal area

27340         Excision, prepatellar bursa

27355         Excision or curettage of bone cyst or benign tumor of femur

Introduction or Removal

27370         Injection procedure for knee arthrography

27372         Removal of foreign body, deep, thigh region or knee area

 

Repair, Revision, and/or Reconstruction

27403         Arthrotomy with open meniscus repair

27435         Capsulotomy, knee, posterior capsular release

 

Fracture and/or Dislocation

 

27500

Closed treatment of femoral shaft fracture, without manipulation

27510

Closed treatment of femoral fracture, distal end, medial or lateral condyle, with manipulation

27516

Closed treatment of distal femoral epiphyseal separation; with manipulation

27520

Closed treatment of patellar fracture, without manipulation

27530

Closed treatment of tibial fracture, proximal (plateau); without manipulation

 

 

 

 

 

27538

Closed treatment of intercondylar spine(s) and/or tuberosity fracture(s)

 

of knee, with or without manipulation

27550

Closed treatment of knee dislocation; without anesthesia

27552

requiring anesthesia

27560

Closed treatment of patellar dislocation; without anesthesia

27562

requiring anesthesia

 

 

27603

Incision and drainage, leg or ankle; deep abscess or hematoma

 

27605

Tenotomy, Achilles tendon, subcutaneous ; local anesthesia

 

27606

general anesthesia

 

27610

Arthrotomy, ankle, for infection, with exploration, drainage

or

 

 
Leg (Tibia and Fibula) and Ankle Joint Incision

 

 

 

 

 

removal of foreign body

27612         Arthrotomy, ankle, posterior capsular release, with or without Achilles tendon lengthening

 

Excision

27620         Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body

27625         Arthrotomy, ankle, with synovectomy

27630         Excision of lesion of tendon sheath or capsule (e.g., cyst or ganglion), leg and/or ankle

27635         Excision or curettage of bone cyst or benign tumor, tibia or fibula

 

Introduction or Removal

27648         Injection procedure for ankle arthrography

 

 

 

Repair, Revision, and/or Reconstruction 27704         Removal of ankle implant

Fracture and/or Dislocation

 

27750

Closed treatment of tibial shaft fracture (with or without fibular fracture); without manipulation

27756

Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (e.g., pins or screws)

27760

Closed treatment of medial malleolus fracture; without manipulation

27780

Closed treatment of proximal fibula or shaft fracture; without manipulation

27781

with manipulation

27786

Closed treatment of distal fibular fracture (lateral malleolus); without manipulation

27788

with manipulation

27808

Closed treatment of bimalleolar ankle fracture, (including Potts); without manipulation

27810

with manipulation

27816

Closed treatment of trimalleolar ankle fracture; without manipulation

27818

with manipulation

27830

Closed treatment of proximal tibiofibular joint dislocation; without anesthesia

27831

requiring anesthesia

27840

Closed treatment of ankle dislocation; without anesthesia

27842

requiring anesthesia, with or without percutaneous skeletal fixation

 

Manipulation

27860         Manipulation of ankle under general anesthesia (includes application of traction or other fixation apparatus)

 

 

 

 

 

Foot and Toes Incision

28020         Arthrotomy, with exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint

28022              metatarsophalangeal joint

28024              interphalangeal joint

28035         Tarsal tunnel release (posterior tibial nerve decompression)

 

Excision

28045              deep, subfascial, intramuscular

28050         Arthrotomy for synovial biopsy; intertarsal or tarsometatarsal joint

28052              metatarsophalangeal joint

28054              interphalangeal joint

28070         Synovectomy; intertarsal or tarsometatarsal joint, each

28072         metatarsophalangeal joint, each

28086         Synovectomy, tendon sheath, foot, flexor

28088              extensor

28090         Excision of lesion of tendon or fibrous sheath or capsule (including synovectomy) (cyst or ganglion); foot

28092              toes

28104         Excision of curettage of bone cyst or benign tumor, tarsal or metatarsal bones, except talus or calcaneus

28110         Ostectomy, partial excision, fifth metatarsal head (bunionette)

28111         Ostectomy, complete excision; first metatarsal head 28112                     other metatarsal head (second, third or fourth) 28113              fifth metatarsal head

 

 

 

 

 

28114

all   metatarsal   heads,   with   partial   proximal       phalangectomy, excluding first metatarsal (Clayton type procedure)

28118

Ostectomy, calcaneus

28119

for spur, with or without plantar fascial release

28120

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) of bone (e.g., for osteomyelitis or talar bossing), talus or calcaneus

28122

Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) of bone (e.g., for osteomyelitis or talar bossing), tarsal or metatarsal bone, except talus or calcaneus

28124

Partial excision (craterization, saucerization, or diaphysectomy) of bone (e.g., for osteomyelitis or dorsal bossing), phalanx of toe

28126

Resection, partial or complete, phalangeal base, single toe, each

28140

Metatarsectomy

28150

Phalangectomy of toe, single, each

28153

Resection, head of phalanx, toe

28160

Hemiphalangectomy or interphalangeal joint excision, toe, single, each

 

Introduction or Removal

28190         Removal of foreign body, foot, subcutaneous

28192              deep

 

Repair, Revision. and/or Reconstruction 28220                  Tenolysis, flexor, foot; single 28222                       multiple (through same incision) 28225         Tenolysis, extensor, foot, single 28226              multiple (through same incision)

28230         Tenotomy, open, flexor; foot, single or multiple

 

 

 

 

 

28232

toe, single

28234

Tenotomy, open, extensor, foot or toe

28285

Hammertoe operation, one toe (e.g., interphalangeal fusion, filleting, phalangectomy)

28286

Cock-up fifth toe operation with plastic skin closure (Ruiz-Mora type procedure)

28288

Ostectomy, partial, exostectomy or condylectomy, single, metatarsal head, first through fifth, each metatarsal head

28292

Keller, McBride or Mayo type procedure

28293

resection of joint with implant

28294

with tendon transplants (Joplin type procedure)

28296

with metatarsal osteotomy (e.g., Mitchell, Chevron, or concentric type procedure)

28297

Lapidus type procedure

28298

by phalanx ostectomy

28299

by other methods (e.g., double osteotomy)

28300

Osteotomy; calcaneus (Dwyer or Chambers type procedure), with or without internal fixation

28302

talus

28304

Ostectomy, midtarsal bones, other than calcaneus or talus;

28306

Osteotomy,   metatarsal,   base   or   shaft,   single,                    with            or      without lengthening, for shortening or angular correction; first metatarsal

28307

first metatarsal with autograft

28308

other than first metatarsal

28309

Osteotomy, metatarsals, multiple, for cavus foot (Swanson type procedure)

28310

Osteotomy for shortening, angular or rotational correction; proximal phalanx, first toe

 

 

 

 

 

28312

other phalanges, any toe

28313

Reconstruction, angular deformity of toe (overlapping second toe, fifth toe, curly toes), soft tissue procedure only

28315

Sesamoidectomy, first toe

28340

Reconstruction, toe, macrodactyly, soft tissue resection

 

Fracture and/or Dislocation

28400

Closed treatment of calcaneal fracture; without manipulation

28405

with manipulation

28406

Percutaneous skeletal fixation of calcaneal fracture; with manipulation

28430

Closed treatment of talus fracture; without manipulation

28435

with manipulation

28436

Percutaneous skeletal fixation of talus fracture, with manipulation

28450

Treatment of tarsal bone fracture (except talus and calcaneus); without manipulation, each

28455

with manipulation, each

28456

Percutaneous skeletal fixation of tarsal bone fracture (except talus and calcaneus), with manipulation, each

28470

Closed treatment of metatarsal fracture; without manipulation, each

28475

with manipulation, each

 

28476         Percutaneous    skeletal    fixation    of                        metatarsal fracture,   with manipulation, each

28490         Closed treatment of fracture great toe, phalanx or phalanges; without manipulation

28495              with manipulation

28496         Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation

 

 

 

 

 

28510

Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each

28515

with manipulation, each

28530

Closed treatment of sesamoid fracture

28540

Closed treatment of tarsal bone dislocation, other than talotarsal; without anesthesia

28545

requiring anesthesia

28546

Percutaneous skeletal fixation of tarsal bone dislocation, other than talotarsal, with manipulation

28570

Closed treatment of talotarsal joint dislocation, without anesthesia

28575

requiring anesthesia

28576

Percutaneous skeletal fixation of talotarsal joint dislocation, with manipulation

28600

Closed   treatment   of   tarsometatarsal   joint              dislocation;      without anesthesia

28605

requiring anesthesia

28606

Percutaneous skeletal fixation of tarsometatarsal joint dislocation, with manipulation

28630

Closed treatment of metatarsophalangeal joint dislocation; without anesthesia

28635

requiring anesthesia

 

28636         Percutaneous    skeletal    fixation    of                        metatarsophalangeal joint dislocation, with manipulation

28660         Closed   treatment   of   interphalangeal   joint              dislocation, without anesthesia

28665              requiring anesthesia

28666         Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation

 

 

 

Arthroscopy

 

29800

Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy

29804

Arthroscopy, temporomandibular joint, surgical

29815

Arthroscopy, shoulder, diagnostic, with or without synovial biopsy

29819

Arthroscopy, shoulder, surgical; with removal of loose body or foreign body

29820

synovectomy, partial

29821

synovectomy, complete

29822

debridement, limited

29823

debridement, extensive

29825

with lysis and resection of adhesions, with or without manipulation

29826

decompression of subacromial space with partial acromioplasty, with or without coracoacromial release

29830

Arthroscopy, elbow, diagnostic, with or without synovial biopsy

29834

Arthroscopy, elbow, surgical; with removal of loose body or foreign body

29835

synovectomy, partial

29836

synovectomy, complete

29837

debridement, limited

29838

debridement, extensive

29840

Arthroscopy, wrist, diagnostic, with or without synovial biopsy

29843

Arthroscopy, wrist, surgical; for infection, lavage and drainage

29844

synovectomy, partial

29845

synovectomy, complete

29846

excision and/or repair of triangular fibrocartilage and/or joint debridement

 

 

 

 

 

29847

internal fixation for fracture or instability

29848

with release of transverse carpal ligament

29860

Arthroscopy, hip, diagnostic with or without synovial biopsy

29861

Arthroscopy, hip, surgical; with removal of loose body or foreign body

29862

with debridement/shaving of articular cartilage (chrondroplasty), abrasion arthroplasty, and/or resection of labrum

29863

with synovectomy

29870

Arthroscopy, knee, diagnostic, with or without synovial biopsy

29871

Arthroscopy, knee, surgical; for infection, lavage and drainage

29874

for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)

29875

synovectomy, limited (e.g., plica or shelf resection)

29876

synovectomy, major, two or more compartments (e.g., medial or lateral)

29877

debridement/shaving of articular cartilage (chondroplasty)

29879

abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling

29880

with meniscectomy (medial AND lateral, including any meniscal shaving)

29881

with meniscectomy (medial OR lateral, including any meniscal shaving)

29882

with meniscus repair (medial OR lateral)

29883

with meniscus repair (medial AND lateral)

29884

with lysis of adhesions, with or without manipulation

29885

drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)

29886

drilling for intact osteochondritis dissecans lesion

 

 

 

 

29887

drilling for intact osteochondritis dissecans lesion with internal fixation

29891

Arthroscopy, ankle, surgical; excision of osteochondral defect of talus and/or tibia, including drilling of the defect

29893

Endoscopic plantar fasciotomy

29894

Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body

29895

synovectomy, partial

29897

debridement, limited

29898

debridement, extensive

Respiratory System

Incision

30020          Drainage abscess or hematoma, nasal septum

Excision

30115        Excision, nasal polyp(s), extensive

30117        Excision or destruction, any method (including laser), intranasal

                  lesion; internal approach

30118        external approach (lateral rhinotomy)

30130        Excision turbinate, partial or complete

30140        Submucous resection turbinate, partial or complete

Introduction

30200         Injection into turbinate(s), therapeutic

30222           Insertion, nasal septal prosthesis (button)

Removal of Foreign Body

 

30310         Removal foreign body, intranasal; requiring general anesthesia

 

Repair

30400         Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip

30410              complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip

30430         Rhinoplasty, secondary; minor revision (small amount of nasal tip work)

30520         Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft

30560         Lysis intranasal synechia

30630         Repair nasal septal perforations

 

Destruction

30801         Cauterization and/or ablation, mucosa of turbinates, unilateral or bilateral, any method; superficial

30802              intramural

Other Procedures

 

30901

Control nasal hemorrhage, anterior, simple (limited cautery and/or

 

30930

packing) any method

Fracture nasal turbinate(s), therapeutic

 

Accessory Sinuses Incision

31000         Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)

31002              sphenoid sinus

31020         Sinusotomy, maxillary (antrotomy); intranasal

 

 

 

31050         Sinusotomy, sphenoid, with or without biopsy

31051              with mucosal stripping or removal of polyp(s)

31070         Sinusotomy frontal; external, simple (trephine operation)

31075              transorbital, unilateral (for mucocele or osteoma, Lynch type)

31090         Sinusotomy combined, three or more sinuses

 

Excision

31200         Ethmoidectomy; intranasal, anterior

31201              intranasal, total

31205              extranasal, total

Endoscopy

31231         Nasal endoscopy, diagnostic, unilateral or bilateral

31233         Nasal/sinus endoscopy, diagnostic with maxillary sinusotomy (via inferior meatus or canine fossa puncture)

31235         Nasal/sinus endoscopy, diagnostic with sphenoid sinusotomy (via puncture of sphenoid face or cannulation of ostium)

31237         Nasal/sinus   endoscopy,   surgical;   with                    biopsy,         polypectomy      or debridement

31238              with control of epistaxis

31254         Nasal/sinus    endoscopy,   surgical;    with                     ethmoidectomy,             partial (anterior)

 

31255

with ethmoidectomy, total (anterior and posterior)

31256

Nasal/sinus endoscopy, surgical, with maxillary antrostomy;

31267

with removal of tissue from maxillary sinus

31276

Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus

31287

Nasal/sinus endoscopy, surgical, with sphenoidotomy;

 

 

 

 

31288

with removal of tissue from the sphenoid sinus

Larynx

 

Endoscopy

 

31505

Laryngoscopy, indirect; diagnostic

31510

with biopsy

31511

with removal of foreign body

31512

with removal of lesion

31515

Laryngoscopy, direct, with or without tracheoscopy; for aspiration

31525

diagnostic, except newborn

31526

diagnostic, with operating microscope

31530

Laryngoscopy, direct, operative, with foreign body removal;

31531

with operative microscope

31535

Laryngoscopy, direct, operative, with biopsy

31536

with operative microscope

31570

Laryngoscopy, direct, with injection into vocal cord(s), therapeutic;

31571

with operating microscope

31575

Laryngoscopy, flexible fiberoptic; diagnostic

31576

with biopsy

31577

with removal of foreign body

31578

with removal of lesion

31579

Laryngoscopy, flexible or rigid fiberoptic; with stroboscopy

 

 

 

 

Trachea and Bronchi

Endoscopy

31622         Bronchoscopy; diagnostic, (flexible or rigid), with or without cell washing or brushing

31625              with biopsy

31628              with transbronchial lung biopsy, with or without fluoroscopic guidance

31629              with transbronchial needle aspiration biopsy

31630              with tracheal or bronchial dilation or closed reduction of fracture

31631              with tracheal dilation and placement of tracheal stent

31635              with removal of foreign body

31645              with therapeutic aspiration of tracheobronchial tree, initial (e.g., drainage of lung abscess)

31646              with therapeutic aspiration of tracheobronchial tree, subsequent

31656              with injection of contrast material for segmental bronchography

31708         Instillation of contrast material for laryngography or bronchography,without catheterization

31720         Catheter aspiration; nasotracheal

31830         Revision of tracheostomy scar

 

Lungs and Pleura

Endoscopy

32601         Thoracoscopy, diagnostic; lungs and pleural space, without biopsy

Heart and Pericardium Pacemaker or Defibrillator

33222   Revision or relocation of skin pocket for pacemaker

Vascular Injection Procedures

Venous

36470         Injection of sclerosing solutions; single vein

36471              multiple veins, same leg

36520         Therapeutic apheresis (plasma and/or cell exchange)

36532         Removal of implantable intervenous infusion pump

36534         Revision of implantable venous access port, and/or subcutaneous reservoir

36535         Removal of implantable venous access port and/or subcutaneous reservoir

Ligation and Other Procedures

37700

Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions

37780

Ligation and division of short saphenous vein at saphenopopliteal junction

 

 

Lymph Nodes and Lymphatic Channels

LYMPH NODES AND LYMPHATIC CHANNELS

Excision

 

38510

Biopsy or excision of lymph node(s); deep cervical node(s)

38520

deep cervical node(s) with excision scalene fat pad

38525

deep axillary node(s)

38530

internal mammary node(s)

 

Mediastinum and Diaphragm Excision

39200         Excision of mediastinal cyst

Endoscopy

39400   Mediastinoscopy, with or without biopsy

Digestive System

Lips Excision

40500         Vermilionectomy (lip shave), with mucosal advancement 40510    Excision of lip; transverse wedge excision with primary closure 40520                  V-excision with primary direct linear closure

40530         Resection of lip, more than one-fourth, without reconstruction

 

Repair

40650         Repair lip, full thickness; vermilion only

40652              up to half vertical height

Vestibule of Mouth Excision, Destruction

40819         Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)

 

Repair

40830         Closure of laceration, vestibule of mouth; 2.5 cm or less

 

PALATE AND UVULA

Incision

42140         Uvulectomy, excision of uvula

 

Repair

     42180         Repair, laceration of palate; up to 2 cm

SALIVARY GLAND AND DUCTS

Excision

42440         Excision of submandibular (submaxillary) gland

42450         Excision of sublingual gland

 

Other Procedures

 

42600

Closure salivary fistula

42650

Dilation salivary duct

42660

Dilation and catheterization of salivary duct, with or without injection

42665

Ligation salivary duct, intraoral

PHARYNX, ADENOIDS, AND TONSILS

Excision, Destruction

42808         Excision or destruction of lesion of pharynx, any method

42809         Removal of foreign body from pharynx

42860         Excision of tonsil tags

Endoscopy

43200         Esophagoscopy,   rigid   or   flexible;                           diagnostic, with         or     without collection of specimen(s) by brushing or washing

43202              with biopsy, single or multiple

43215              with removal of foreign body

43216              with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

43217              with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

43220              with balloon dilation (less than 30 mm diameter)

 

     43226              with insertion of guide wire followed by dilation over guide wire

43234         Upper gastrointestinal endoscopy, simple primary examination (e.g., with small diameter flexible endoscope)

 

43235

Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing

43239

with biopsy, single or multiple

43241

with transendoscopic tube or catheter placement

43243

with injection sclerosis of esophageal and/or gastric varices

43247

with removal of foreign body

43248

with insertion of guide wire followed by dilation of esophagus over guide wire

43249

with balloon dilation of esophagus (less than 30 mm diameter)

43250

with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

43251

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

43258

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

43259

with endoscopic ultrasound examination

43260

Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or washing

43261

with biopsy, single or multiple

43262

with sphincterotomy/papillotomy

43264

with endoscopic retrograde removal of stone(s) from biliary and/or pancreatic ducts

43265

with endoscopic retrograde destruction, lithotripsy of stone(s), any method

 

     43269              with endoscopic retrograde removal of foreign body and/or change of tube or stent

 

Manipulation

43450         Dilation of esophagus, by unguided sound or bougie, single or multiple passes

43453         Dilation of esophagus, over guide wire

43456         Dilation of esophagus, by balloon or dilator, retrograde

43458         Dilation of esophagus with balloon (30 mm diameter or larger) for achalasia

 

Stomach Excision

43600         Biopsy of stomach; by capsule, tube, peroral (one or more specimens)

 

Introduction

43750         Percutaneous placement of gastrostomy tube

43760         Change of gastrostomy tube

 

Intestines (Except Rectum) Excision

44100         Biopsy of intestine by capsule, tube, peroral (one or more specimens) 44340 Revision of colostomy; simple (release of superficial scar) Endoscopy, Small Bowel and Stomal

44360

Small intestinal endoscopy, enteroscopy beyond second portion of

 

duodenum, not including ileum, diagnostic, with or without collection

 

44361

of specimen(s) by brushing or washing

with biopsy, single or multiple

44363

with removal of foreign body

 

 

 

 

 

44364

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

44365

with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

44366

with control of bleeding, any method

44369

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

44376

Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing

44377

with biopsy, single or multiple

44378

with control of bleeding, any method

44380

Ileoscopy, through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing

44382

with biopsy, single or multiple

44385

Endoscopic evaluation of small intestinal (abdominal or pelvic) pouch; diagnostic, with or without collection of specimen(s) by brushing or washing

44386

with biopsy, single or multiple

44388

Colonoscopy, through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing

44389

with biopsy, single or multiple

44390

with removal of foreign body

44391

with control of bleeding, any method

44392

with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

44393

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

44394

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

 

    Rectum Incision

45005        Incision and drainage of submucosal abscess, rectum

45020        Incision and drainage of deep supralevator, pelvirectal, or retrorectal abscess

 

Excision

45100        Biopsy or anorectal wall, anal approach (e.g., congenital megacolon)

45170        Excision of rectal tumor, transanal approach

45190        Destruction  of    rectal tumor, any method (e.g., electrodesiccation) transanal approach

 

Endoscopy

 

45300

Proctosigmoidoscopy, rigid; diagnostic, with or without collection of specimen(s) by brushing or washing

45303

with dilation, any method

45305

with biopsy, single or multiple

45307

with removal of foreign body

45308

with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery

45309

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

45315

with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique

45320

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (e.g., laser)

45321

with decompression of volvulus

45330

Sigmoidoscopy, flexible; diagnostic, with or without collection of

 

 

 

 

 

specimen(s) by brushing or washing

45331

with biopsy, single or multiple

45332

with removal of foreign body

45333

with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

45334

with control of bleeding, any method

45337

with decompression of volvulus, any method

45338

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

45339

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

45355

Colonoscopy, rigid or flexible, transabdominal via colostomy, single or multiple

45378

Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression

45379

with removal of foreign body

45380

with biopsy, single or multiple

45382

with control of bleeding, any method

45383

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

45384

with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery

45385

with removal of tumor(s), polyp(s), or other lesion(s) by snare technique

 

Manipulation

45905        Dilation of anal sphincter under anesthesia other than local

45910        Dilation of rectal stricture under anesthesia other than local

 

 

 

45915        Removal of fecal impaction or foreign body under anesthesia

Anus Incision

46040         Incision and drainage of ischiorectal and/or perirectal abscess

46045         Incision and drainage of intramural, intramuscular, or submucosal abscess, transanal, under anesthesia

46050         Incision and drainage, perianal abscess, superficial

46060 Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton

46080         Sphincterotomy, anal, division of sphincter

46083         Incision of thrombosed hemorrhoid, external

 

Excision

46250         Hemorrhoidectomy, external, complete

46255         Hemorrhoidectomy, internal and external, simple;

46257              with fissurectomy

46258              with fistulectomy, with or without fissurectomy

46260         Hemorrhoidectomy, internal and external, complex or extensive;

46261              with fissurectomy

46262              with fistulectomy, with or without fissurectomy

46270 Surgical treatment of  anal  fistula  (fistulectomy/fistulotomy); subcutaneous

46275              submuscular

46320              Enucleation or excision of external thrombotic hemorrhoid

 

 

 

Endoscopy

 

 

 

 

 

46600

Anoscopy; diagnostic, with or without collection of specimen(s) by brushing or washing

46604

with dilation, any method

46606

with biopsy, single or multiple

46608

with removal of foreign body

46610

with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery

46611

with removal of single tumor, polyp, or other lesion by snare technique

46612

with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique

46614

with control of bleeding, any method

46615

with ablation of tumor(s), polyp(s), or other lesion(s), not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique

 

Destruction

46922         Destruction of lesion(s), anus (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision

46924         Destruction of lesion(s), anus (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive, any method

46934         Destruction of hemorrhoids, any method; internal

46935              external

46936              internal and external

 

Suture

46945         Ligation of internal hemorrhoids; single procedure

46946              multiple procedures

 

Abdomen, Peritoneum, and Omentum

 

 

 

 

 

Introduction, Revision, and/or Removal

47525         Change of percutaneous biliary drainage catheter

47530         Revision and/or reinsertion of transhepatic tube

49422         Removal of permanent intraperitoneal cannula or catheter

 

Repair

49500         Repair initial inguinal hernia, age 6 months to under 5 years, with or without hydrocelectomy; reducible

49570         Repair epigastric hernia (e.g., preperitoneal fat); reducible

49580         Repair umbilical hernia, under age 5 years; reducible

Urinary System

Bladder Introduction

50390         Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous

 

Other Procedures

50590         Lithotripsy, extracorporeal shock wave

Ureter Introduction

50686         Manometric studies through ureterostomy or indwelling ureteral catheter

 

Bladder

51705         Change of cystostomy tube; simple

51710              complicated

51715      Endoscopic injection of implant material into the submucosal tissues    of the urethra and/or bladder neck

Endoscopy--Cystoscopy, Urethroscopy, Cystourethroscopy

 

52000

Cystourethroscopy

52005

Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service

52007

with brush biopsy of ureter and/or renal pelvis

52010

Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service

Transurethral Surgery Urethra and Bladder

52204         Cystourethroscopy, with biopsy

52214 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands

 

52224

Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of MINOR (less 0.5 cm) lesion(s) with or without biopsy

52260

Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia

52265

local anesthesia

52281

Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy and injection procedure for cystography, male or female

52282

Cystourethroscopy, with insertion of urethral stent

52310

Cystourethroscopy, with removal of foreign body calculus, or ureteral stent from urethra or bladder; simple

52315

complicated

52317

Litholapaxy; crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)

 

    Ureter and Pelvis

52320         Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus

52325              with fragmentation of ureteral calculus (e.g., ultrasonic or electro- hydraulic technique)

52327              with subureteric injection of implant material

52330              with manipulation, without removal of ureteral calculus

52335         Cystourethroscopy, with ureteroscopy and/or pyeloscopy (includes dilation of the ureter and/or pyeloureteral junction by any method);

52336              with removal or manipulation of calculus (ureteral catheterization is included)

52337              with lithotripsy (ureteral catheterization is included)

52338              with biopsy and/or fulguration of lesion

52510         Transurethral balloon dilation of the prostatic urethra, any method

 

Urethra Incision

53020         Meatotomy, cutting of meatus; except infant

53025              infant

Manipulation

 

53600

Dilation of urethral stricture by passage of sound or urethral dilator, male, initial

53601

subsequent

53605

Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia

53620

Dilation of urethral stricture by passage of filiform and follower, male; initial

 

53621              subsequent

53660         Dilation of female urethra including suppository and/or instillation; initial

53661              subsequent

53665         Dilation of female urethra, general or conduction (spinal) anesthesia

Male Genital System

Penis Excision

54115         Removal foreign body from deep penile tissue (e.g., plastic implant)

54152         Circumcision, using clamp or other device; except newborn

54161         Circumcision, surgical excision other than clamp, device, or dorsal slit; except newborn

 

Testis Excision

54505                  Biopsy of testis, incisional

54550                  Exploration for undescended testis (inguinal or scrotal area)

54820                  Exploration of epididymis, with or without biopsy

 

Tunica Vaginalis

55000                  Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication

55040                  Excision of hydrocele; unilateral

55041                       bilateral

 

Vas Deferens

Incision

55200         Vasotomy, cannulization with or without incision of vas, unilateral or bilateral

55250         Vasectomy , unilateral or bilateral, including postoperative semen examination(s)

 

Introduction

 

55300

Vasotomy for vasograms, seminal vesiculograms, or epididymograms,

 

55450

unilateral or bilateral

Ligation (percutaneous) of vas deferens, unilateral or bilateral

Female Genital System

Laparoscopy/Peritoneoscopy/Hysteroscopy

 

56300

Laparoscopy, diagnostic

56301

Laparoscopy, surgical; with fulguration of oviducts (with or without transection)

56302

with occlusion of oviducts by device (e.g., band, clip, or Falope ring)

56306

with aspiration (single or multiple)

56350

Hysteroscopy, diagnostic

56351

Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C

56352

with lysis of intrauterine adhesions (any method)

56353

with division or resection of intrauterine septum (any method)

 

 

 

Vulva, Perineum and Introitus

 

Incision

56441         Lysis of labial adhesions

Destruction

56515              extensive, any method

Excision

56740         Excision of Bartholin’s gland or cyst

Vagina Excision

57108         Colpectomy, obliteration of vagina; partial

57120         Colpocleisis (Le Fort type)

57135         Excision of vaginal cyst or tumor

 

Manipulation

 

57400

Dilation of vagina under anesthesia

57410

Pelvic examination under anesthesia

57415

Removal of impacted vaginal foreign body under anesthesia

Cervix Uteri Excision

57500

Biopsy, single or multiple, or local excision of lesion, with or without

 

fulguration

57505

Endocervical curettage (not done as part of a dilation and curettage)

57510

Cauterization of cervix; electro or thermal

57511

cryocautery, initial or repeat

57513

laser ablation

57520

Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser

 

57522              loop electrode excision

57700         Cerclage of uterine cervix, nonobstetrical

 

Manipulation

57800         Dilation of cervical canal, instrumental 57820         Dilation and curettage of cervical stump Corpus Uteri

Excision

58100         Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method

58120         Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical)

58340         Catheterization and introduction of saline or contrast material for hysterosonography or hysterosalpingography

 

Oviduct Incision

58600         Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral

58615         Occlusion of fallopian tube(s) by device (e.g., band, clip, Falope ring) vaginal or suprapubic approach

 

Ovary Incision

58800         Drainage of ovarian cyst(s), unilateral or bilateral; vaginal approach

Excision

58900         Biopsy of ovary, unilateral or bilateral

Maternity Care and Delivery

Incision

59000 Amniocentesis, any method

59020 Fetal contraction stress test

59025 Fetal non-stress test

Nervous System

Spine and Spinal Cord

Injection, Drainage, or Aspiration

 

62268

Percutaneous aspiration, spinal cord cyst or syrinx

62269

Biopsy of spinal cord, percutaneous needle

62270

Spinal puncture, lumbar, diagnostic

62272

Spinal puncture, therapeutic, for drainage of spinal fluid (by needle or catheter)

62284

Injection procedure for myelography and/or computerized axial tomography, spinal (other than C1-C2 and posterior fossa)

62287         Aspiration    procedure,   percutaneous,   of nucleus pulposus of intervertebral disk, any method, single or multiple levels, lumbar

 

62290

Injection procedure for diskography, each level; lumber

62291

cervical

62365

Removal of  subcutaneous reservoir pump,  previously implanted                                                                               for intrathecal or epidural infusion

 

Somatic Nerves Excision

64774         Excision of neuroma; cutaneous nerve, surgically identifiable

64776              digital nerve, one or both, same digit

 

64778

digital nerve, each additional digit

64782

hand or foot, except digital nerve

64783

hand or foot, each additional nerve, except same digit

64788

Excision of neurofibroma or neurolemmoma; cutaneous nerve

64795

Biopsy of nerve

Eye and Ocular Adnexa

Eyeball

Secondary Implant(s) Procedure

65175              Removal of ocular implant

Anterior Segment

Cornea

65410         Biopsy of cornea

Excision

65420         Excision or transposition of pterygium; without graft

 

Removal or Destruction

 

65430

Scraping of cornea, diagnostic, for smear and/or culture

65435

Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage)

65436

with application of chelating agent (e.g., EDTA)

65450

Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization

 

 

 

Anterior Sclera

 

Excision

66130         Excision of lesion, sclera

Lens Incision

66820 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); stab incision technique (Ziegler or Wheeler knife)

66821              laser surgery (e.g., YAG laser) (one or more stages)

Removal Cataract

66830              Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy)

66986         Exchange of intraocular lens

67027 Implantation or replacement of intravitreal drug delivery system (e.g., ganciclovir implant), includes concomitant removal of vitreous

67120         Removal of implanted material, posterior segment; extraocular

67121              intraocular

 

Eyelids

 

Repair (Brow Ptosis, Blepharoptosis, Lid Retraction, Ectropion, Entropion)

 

67900

Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)

67901

Repair of blepharoptosis; frontalis muscle technique with suture or other material

67902

frontalis muscle technique with fascial sling (includes obtaining fascia)

67914         Repair of ectropion; suture

67915              thermocauterization

67916              blepharoplasty, excision tarsal wedge

 

67917

blepharoplasty, extensive (e.g., Kuhnt-Szymanowski or tarsal strip

 

operations)

67921

Repair of entropion; suture

67922

thermocauterization

67923

blepharoplasty, excision tarsal wedge

67924

blepharoplasty, extensive (e.g., Wheeler operation)

67938

Removal of embedded foreign body, eyelid

 

Reconstruction

67950         Canthoplasty

Conjunctiva

Incision and Drainage

68040         Expression of conjunctival follicles (e.g., for trachoma)

 

Excision and/or Destruction 68100          Biopsy of conjunctiva

68110         Excision of lesion, conjunctiva; up to 1 cm

Lacrimal System

Probing and/or Related Procedures

 

68811

requiring general anesthesia

68815

with insertion of tube or stent

68850

Injection of contrast medium for dacryocystography

 

 

Removal of Foreign Body

     69205         Removal of foreign body from external auditory canal; with general anesthesia

 

Repair

69300         Otoplasty, protruding ear, with or without size reduction

Incision

69420         Myringotomy including aspiration and/or eustachian tube inflation

69421         Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia

69424         Ventilating   tube   removal   when   originally                    inserted             by       another physician

69433         Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia

69436         Tympanostomy (requiring insertion of ventilating tube), general anesthesia

 

Excision

69540         Excision aural polyp

Repair

69610         Tympanic membrane repair, with or without site preparation or perforation for closure, with or without patch

69620         Myringoplasty (surgery confined to drumhead and donor area)

Radiology

72240         Myelography, cervical, radiological supervision and interpretation

72255      Myelography, thoracic, radiological supervision and interpretation

72265                  Myelography, lumbosacral, radiological supervision and interpretation

72270         Myelography,   entire   spinal   canal,  radiological supervision and interpretation

72285         Diskography, cervical, radiological supervision and interpretation

 

72295

Diskography, lumbar, radiological supervision and interpretation

75552

Cardiac magnetic resonance imaging for morphology; without contrast material

75553

with contrast material

Medicine

Peritoneal Dialysis

90945

Dialysis procedure other than hemodialysis (e.g., peritoneal, hemofiltration), with single physician evaluation

 

90947  Dialysis procedure other than hemodialysis (e.g., peritoneal, hemofiltration), requiring repeated evaluations, with or without substantial revision of dialysis presription

 

 

Special Ophthalmological Services

 

92018  Ophthalmological  examination  and  evaluation,  under  general anesthesia, with or without manipulation of globe for passive range of motion or other manipulation to facilitate diagnostic examination; complete

92019              limited

 

 

Special Otorhinolaryngologic Services

 

92502         Otolaryngologic examination under general anesthesia

92511         Nasopharyngoscopy with endoscope