Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) 31231 Nasal endoscopy, diagnostic, unilateral or bilateral (separate procedure) X 31233 Nasal/sinus endoscopy, diagnostic with maxillary sinusoscopy (via X inferior meatus or canine fossa puncture) 31235 Nasal/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via X puncture of sphenoidal face or cannulation of ostium) 31237 Nasal/sinus endoscopy, surgical; with biopsy, polypectomy or X debridement (separate procedure) 31238 Nasal/sinus endoscopy, surgical; with control of hemorrhage X 31239 Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy X 31240 Nasal/sinus endoscopy, surgical; with concha bullosa resection X 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery X 31253 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior X and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performed 31254 Nasal/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior) X 31255 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior X and posterior 31256 Nasal/sinus endoscopy, surgical; with maxillary antrostomy X 31257 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior X and posterior), including sphenoidotomy 31259 Nasal/sinus endoscopy, surgical; with ethmoidectomy, total (anterior X and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinus 31267 Nasal/sinus endoscopy, surgical; with removal of tissue from maxillary X sinus 31276 Nasal/sinus endoscopy, surgical with frontal sinus exploration, with or X without removal of tissue from frontal sinus 31287 Nasal/sinus endoscopy, surgical, with sphenoidotomy X 31288 Nasal/sinus endoscopy, surgical, with sphenoidotomy; with removal of X tissue from sphenoid sinus 31290 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; X ethmoid region 31291 Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; X sphenoid region 31292 Nasal/sinus endoscopy, surgical; with medial or inferior orbital wall X decompression 31293 Nasal/sinus endoscopy, surgical; with medial orbital wall and inferior X orbital wall decompression 31294 Nasal/sinus endoscopy, surgical; with optic nerve decompression X 31295 Nasal/sinus endoscopy, surgical; with dilation of maxillary sinus ostium, X transnasal or via canine fossa 31296 Nasal/sinus endoscopy, surgical; with dilation of frontal sinus ostium X 31297 Nasal/sinus endoscopy, surgical; with dilation of spenoid sinus ostium X 31298 Nasal/sinus endoscopy, surgical; with dilation of frontal sphenoid sinus X osia (such as balloon dilation) 31505 Laryngoscopy, indirect; diagnostic (separate procedure) X 31510 Laryngoscopy, indirect; with biopsy X 31511 Laryngoscopy, indirect; with removal of foreign body X 31512 Laryngoscopy, indirect; with removal of lesion X 31513 Laryngoscopy, indirect; with vocal cord injection X 31515 Laryngoscopy, direct, with or without tracheoscopy; for aspiration X 31520 Laryngoscopy, direct, with or without tracheoscopy; diagnostic, newborn X 31525 Laryngoscopy, direct, with or without tracheoscopy; diagnostic, except X newborn 31526 Laryngoscopy, direct, with or without tracheoscopy; diagnostic, with X operating microscope Effective January 1, 2018 2
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) 31527 Laryngoscopy, direct, with or without tracheoscopy; with insertion of X obturator 31528 Laryngoscopy, direct, with or without tracheoscopy; with dilation, initial X 31529 Laryngoscopy, direct, with or without tracheoscopy; with dilation, X subsequent 31530 Laryngoscopy, direct, operative with foreign body removal X 31531 Laryngoscopy, direct, operative with foreign body removal; with X operating microscope 31535 Laryngoscopy, direct, operative, with biopsy X 31536 Laryngoscopy, direct, operative, with biopsy; with operating microscope X 31540 Laryngoscopy, direct, operative, with excision of tumor and/or stripping X of vocal cords or epiglottis 31541 Laryngoscopy, direct, operative, with excision of tumor and/or stripping X of vocal cords or epiglottis; with operating microscope 31545 Laryngoscopy, direct, operative, with operating microscope or X telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s) 31546 Laryngoscopy, direct, operative, with operating microscope or X telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with graft(s) (includes obtaining autograft) 31560 Laryngoscopy, direct, operative, with arythenoidectomy X 31561 Laryngoscopy, direct, operative, with arythenoidectomy; with operating X microscope 31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic X 31571 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with X operating microscope 31572 Laryngoscopy, flexible; with ablation or destruction of lesion(s) with X laser, unilateral 31573 Laryngoscopy, flexible; with therapeutic injection(s) (eg, X chemodenervation agent or corticosteroid, injected percutaneous, transoral, or via endoscope channel), unilateral 31574 Laryngoscopy, flexible; with injection(s) for augmentation (eg, X percutaneous, transoral), unilateral 31575 Laryngoscopy, flexible fiberoptic; diagnostic X 31576 Laryngoscopy, flexible fiberoptic; with biopsy X 31577 Laryngoscopy, flexible fiberoptic; with removal of foreign body X 31578 Laryngoscopy, flexible fiberoptic; with removal of lesion X 31579 Laryngoscopy, flexible or rigid fiberoptic, with stroboscopy X 31615 Tracheobronchoscopy through established tracheostomy incision X 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, X diagnostic, with cell washing when performed (separate procedure) 31623 Bronchoscopy, rigid or flexible, with brushing or protected brushings X 31624 Bronchoscopy, rigid or flexible, with bronchial alveolar lavage X 31625 Bronchoscopy, rigid or flexible, with bronchial or endobronchial X biopsy(s), single or multiple sites 31626 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, X diagnostic, with placement of fiduciary markers, single or multiple 31627 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, X diagnostic, with computer assisted image guided navigation (List separately in addition to code for primary procedure) 31628 Bronchoscopy, rigid or flexible with transbronchial lung biopsy(s) single X lobe 31629 Bronchoscopy, rigid or flexible, with transbronchial needle aspiration X biopsy(s), trachea, main stem and/or lobar bronchus(i) 31630 Bronchoscopy, rigid or flexible, with tracheal/ bronchial dilation or closed X reduction of fracture 31631 Bronchoscopy, rigid or flexible with placement of tracheal stent(s) X Effective January 1, 2018 3
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) (includes tracheal/bronchial dilation as required) 31632 X Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), each additional lobe (list separately in addition to code for primary procedure) 31633 X Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial needle aspiration biopsy(s), each additional lobe (list separately in addition to code for primary procedure) 31634 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when X performed; with balloon occlusion, with assessment of air leak, with administration of occlusive substance (for example fibrin glue), if performed procedure) 31635 Bronchoscopy, rigid or flexible, with removal of foreign body X 31636 Bronchoscopy, rigid or flexible, with placement of bronchial stent(s) X (includes tracheal/bronchial dilation as required), initial bronchus 31637 Bronchoscopy, rigid or flexible, each additional major bronchus stented X (list separately in addition to code for primary procedure) 31638 Bronchoscopy, rigid or flexible, with revision of tracheal or bronchial X stent inserted at previous session (includes tracheal/bronchial dilation as required) 31640 Bronchoscopy, rigid or flexible, with excision of tumor X 31641 Bronchoscopy, (rigid or flexible); with destruction of tumor or relief of X stenosis by any method other than excision (for example laser therapy, cryotherapy) 31643 Bronchoscopy, (rigid or flexible); with placement of catheter (s) for X intracavitary radioelement application 31645 Bronchoscopy, (rigid or flexible); with therapeutic aspiration of X thracheobronchial tree, initial (for example, drainage of lung abscess) 31646 Bronchoscopy, (rigid or flexible); with therapeutic aspiration of X tracheobronchial tree, subsequent 31647 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when X performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), initial lobe 31648 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when X performed; with removal of bronchial valve(s), initial lobe 31649 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when X performed; with removal of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure) 31651 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when X performed; with balloon occlusion, when performed, assessment of air leak, airway sizing, and insertion of bronchial valve(s), each additional lobe (List separately in addition to code for primary procedure[s]) X 3165 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 2 performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures X 3165 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 3 performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures X 3165 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 4 performed; with transendoscopic endobronchial ultrasound (EBUS) during bronchoscopic diagnostic or therapeutic intervention(s) for Effective January 1, 2018 4
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) peripheral lesion(s) (list separately in addition to code for primary procedure[s]) 32601 Thoracoscopy, diagnostic (separate procedure); lungs and pleural X space, without biopsy 32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, with X biopsy 32606 Thoracoscopy, diagnostic (separate procedure); mediastinal space, with X biopsy 32607 Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (for X example wedge, incisional), unilateral 32608 Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) X (for example wedge, incisional), unilateral 32609 Thoracoscopy; with biopsy(ies) of pleura X 32650 Thoracoscopy, surgical; with pleurodesis (for example, mechanical or X chemical) any method 32651 Thoracoscopy, surgical; with partial pulmonary decortication X 32652 Thoracoscopy, surgical; with total pulmonary decortication, including X intrapleural pneumonolysis 32653 Thoracoscopy, surgical; with removal of intrapleural foreign body or X fibrin deposit 32654 Thoracoscopy, surgical; with control of traumatic hemorrhage X 32655 Thoracoscopy, surgical; with excision-plication of bullae, including any X pleural procedure 32656 Thoracoscopy, surgical; with parietal pleurectomy X 32658 Thoracoscopy, surgical; with removal of clot or foreign body from X pericardial sac 32659 Thoracoscopy, surgical; with creation of pericardial window or partial X resection of pericardial sac for drainage 32661 Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or mass X 32662 Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or X mass 32663 Thoracoscopy, surgical; with lobectomy, total or segmental X 32664 Thoracoscopy, surgical; with thoracic sympathectomy X 32665 Thoracoscopy, surgical; with esophagomyotomy (Heller type) X 32666 Thoracoscopy, surgical; with therapeutic wedge resection (for example X mass, nodule), initial unilateral 32667 Thoracoscopy, surgical; with therapeutic wedge resection (for example X mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure) 32668 Thoracoscopy, surgical; with diagnostic wedge resection followed by X anatomic lung resection (List separately in addition to code for primary procedure) 32669 Thoracoscopy, surgical; with removal of a single lung segment X (segmentectomy) 32670 Thoracoscopy, surgical; with removal of 2 lobes (bilobectomy) X 32671 Thoracoscopy, surgical; with removal of lung (pneumonectomy) X 32672 Thoracoscopy, surgical; with resection-plication for emphysematous X lung (bullous or non-bullous) for lung volume reduction (LVRS), unilateral includes any pleural procedure, when performed 32673 Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral X 32674 Thoracoscopy, surgical; with mediastinal and regional X lymphadenectomy (List separately in addition to code for primary procedure) X 3940 Mediastinoscopy; includes biopsy(ies) of mediastinal mass (e.g., 1 lymphoma), when performed
Effective January 1, 2018 5
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) X 3940 Mediastinoscopy; with lymph node biopsy(ies) (e.g., lung cancer 2 staging) 43180 Esophagoscopy, rigid, transoral with diverticulectomy of hypopharynx or X cervical esophagus (for example Zenker's diverticulum), with cricopharyngeal myotomy, includes use of telescope or operating microscope and repair, when performed
43191 Esophagoscopy, rigid, transoral; diagnostic, including collection of X specimen(s) by brushing or washing when performed (separate procedure) 43192 Esophagoscopy, rigid, transoral; with directed submucosal injection(s), X any substance 43193 Esophagoscopy, rigid, transoral; with biopsy, single or multiple X 43194 Esophagoscopy, rigid, transoral; with removal of foreign body(s) X 43195 Esophagoscopy, rigid, transoral; with balloon dilation (less than 30 mm X diameter) 43196 Esophagoscopy, rigid, transoral; with insertion of guide wire followed by X dilation over guide wire 43197 Esophagoscopy, flexible, transnasal; diagnostic, including collection of X specimen(s) by brushing or washing when performed (separate procedure) 43198 Esophagoscopy, flexible, transnasal; with biopsy, single or multiple X 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of X specimen(s) by brushing or washing when performed (separate procedure) 43201 Esophagoscopy, flexible, transoral diagnostic, with directed submucosal X injection(s), any substance 43202 Esophagoscopy, flexible, transoral; with biopsy, single or multiple X 43204 Esophagoscopy, flexible, transoral; with injection sclerosis of X esophageal varices 43205 Esophagoscopy, flexible, transoral; with band ligation of esophageal X varices 43206 Esophagoscopy, flexible, transoral with optical endomicroscopy X
43210 Esophagogastroduodenoscopy, flexible, transoral; with X esophagogastric fundoplasty, partial or complete, includes duodenoscopy when performed 43211 Esophagoscopy, flexible, transoral; with endoscopic mucosal resection X 43212 Esophagoscopy, flexible, transoral; with placement of endoscopic stent X (includes pre- and post-dilation and guide wire passage, when performed) 43213 Esophagoscopy, flexible, transoral; with dilation of esophagus, by X balloon or dilator, retrograde (includes fluoroscopic guidance, when performed) 43214 Esophagoscopy, flexible, transoral; with dilation of esophagus with X balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) 43215 Esophagoscopy, flexible, transoral; with removal of foreign body(s) X 43216 Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), X or other lesions(s) by hot biopsy forceps 43217 Esophagoscopy, flexible, transoral; with removal of tumor(s), polyp(s), X or other lesion(s) by snare technique 43220 Esophagoscopy, flexible, transoral; with balloon dilation (less than 30 X mm diameter) 43226 Esophagoscopy, flexible, transoral; with insertion of guide wire followed X by dilator(s) over guide wire Effective January 1, 2018 6
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) 43227 Esophagoscopy, flexible, transoral; with control of bleeding any method X 43229 Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or X other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) 43231 Esophagoscopy, flexible, transoral; with endoscopic ultrasound X examination 43232 Esophagoscopy, flexible, transoral; with transendoscopic ultrasound- X guided intramural or transmural fine needle aspiration/biopsy(s) 43233 Esophagogastroduodenoscopy, flexible, transoral; with dilation of X esophagus with balloon (30 mm diameter or larger) (includes fluoroscopic guidance, when performed) 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including X collection of specimen(s) by brushing or washing, when performed (separate procedure) 43236 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with X directed submucosal injection(s), any substance 43237 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with X endoscopic ultrasound examination limited to the esophagus 43238 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, with X transendoscopic ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s), esophagus (includes endoscopic ultrasound examination limited to the esophagus) 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or X multiple 43240 Esophagogastroduodenoscopy, flexible, transoral; with transmural X drainage of pseudocyst (includes placement of transmural drainage catheter[s]/stent[s], when performed, and endoscopic ultrasound, when performed) 43241 Esophagogastroduodenoscopy, flexible, transoral; with insertion of X intraluminal tube or catheter 43242 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic X ultrasound-guided intramural or transmural fine needle aspiration/biopsy(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis) 43243 Esophagogastroduodenoscopy, flexible, transoral; with injection X sclerosis of esophageal/gastric varices 43244 Esophagogastroduodenoscopy, flexible, transoral; with band ligation of X esophageal/gastric varices 43245 Esophagogastroduodenoscopy, flexible, transoral; with dilation of X gastric/duodenal stricture(s) (for example balloon, bougie) 43246 Esophagogastroduodenoscopy, flexible, transoral; with directed X placement of percutaneous gastrostomy tube 43247 Esophagogastroduodenoscopy, flexible, transoral; with removal of X foreign body(s) 43248 Esophagogastroduodenoscopy, flexible, transoral; with insertion of X guide wire followed by passage of dilator(s) through esophagus over guide wire 43249 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic X balloon dilation of esophagus (less than 30 mm diameter) 43250 Esophagogastroduodenoscopy, flexible, transoral; with removal of X tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps 43251 Esophagogastroduodenoscopy, flexible, transoral; with removal of X tumor(s), polyp(s), or other lesion(s) by snare technique 43252 Esophagogastroduodenoscopy, flexible, transoral; with optical X endomicroscopy 43253 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic X ultrasound-guided transmural injection of diagnostic or therapeutic Effective January 1, 2018 7
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) substance(s) (for example anesthetic, neurolytic agent) or fiducial marker(s) (includes endoscopic ultrasound examination of the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis) 43254 Esophagogastroduodenoscopy, flexible, transoral; with endoscopic X mucosal resection 43255 Esophagogastroduodenoscopy, flexible, transoral; with control of X bleeding, any method 43257 Esophagogastroduodenoscopy, flexible, transoral; with delivery of X thermal energy to the muscle of lower esophageal sphincter and/or gastric cardia, for treatment of gastroesophageal reflux disease 43259 Esophagogastroduodenoscopy, flexible, transoral; with endoscopic X ultrasound examination, including the esophagus, stomach, and either the duodenum or a surgically altered stomach where the jejunum is examined distal to the anastomosis 43260 Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, X including collection of specimen(s) by brushing or washing (separate procedures) 43261 Endoscopic retrograde cholangiopancreatography (ERCP); with biopsy, X single or multiple 43262 Endoscopic retrograde cholangiopancreatography (ERCP); with X sphincterotomy/papillotomy 43263 Endoscopic retrograde cholangiopancreatography (ERCP); with X pressure measurement of sphincter of Oddi (pancreatic duct or common bile duct) 43264 Endoscopic retrograde cholangiopancreatography (ERCP); with X endoscopic retrograde removal of calculus/calculi from biliary and/or pancreatic ducts 43265 Endoscopic retrograde cholangiopancreatography (ERCP); with X endoscopic retrograde destruction, lithotripsy of calculus/calculi, any method 43266 Esophagogastroduodenoscopy, flexible, transoral; with placement of X endoscopic stent (includes pre- and post-dilation and guide wire passage, when performed) 43270 Esophagogastroduodenoscopy, flexible, transoral; with ablation of X tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) 43273 Endoscopic cannulation of papilla with direct visualization of X pancreatic/common bile duct(s) (List separately in addition to code(s) for primary procedure) 43274 Endoscopic retrograde cholangiopancreatography (ERCP); with X placement of endoscopic stent into biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent 43275 Endoscopic retrograde cholangiopancreatography (ERCP); with removal X of foreign body(s) or stent(s) from biliary/pancreatic duct(s) 43276 Endoscopic retrograde cholangiopancreatography (ERCP); with removal X and exchange of stent(s), biliary or pancreatic duct, including pre- and post-dilation and guide wire passage, when performed, including sphincterotomy, when performed, each stent exchanged 43277 Endoscopic retrograde cholangiopancreatography (ERCP); with trans- X endoscopic balloon dilation of biliary/pancreatic duct(s) or of ampulla (sphincteroplasty), including sphincterotomy, when performed, each duct 43278 Endoscopic retrograde cholangiopancreatography (ERCP); with ablation X of tumor(s), polyp(s), or other lesion(s), including pre- and post-dilation and guide wire passage, when performed 43284 Laparoscopy, surgical, esophageal sphincter augmentation procedure, X Effective January 1, 2018 8
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) placement of sphincter augmentation device (ie, magnetic band), including cruroplasty when performed 43285 Removal of esophageal sphincter augmentation device X 44360 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedures 44361 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with biopsy, single or multiple 44363 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with removal of foreign body 44364 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with removal of tumor(s), polyp(s) or other lesion(s) by snare technique 44365 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with removal of tumor(s), polyp(s) or other lesion(s) by hot biopsy forceps or bipolar cautery 44366 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with control of bleeding (for example, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) 44369 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, 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 44370 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with transendoscopic stent placement (includes predilation) 44372 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with placement of percutaneous jejunostomy tube 44373 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, not including ileum; with conversion of percutaneous gastrostomy tube to percutaneous jejunosotomy tube 44376 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, including ileum; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) 44377 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, including ileum; with biopsy, single or multiple 44378 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, including ileum; with control of bleeding, (for example, injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) 44379 Small intestinal endoscopy, enteroscopy beyond second portion of X duodenum, including ileum; with transendoscopic stent placement (includes predilation) 44380 Ileoscopy, through stoma; diagnostic, including collection of specimen(s) X by brushing or washing, when performed(separate procedure) 44381 Ileoscopy, through stoma; with transendoscopic balloon dilation X 44382 Ileoscopy, through stoma; with biopsy, single or multiple X 44384 Ileoscopy, through stoma; with placement of endoscopic stent (includes X pre and post-dilation and guide wire passage, when performed) 44385 Endoscopic evaluation of small intestinal pouch (for example Kock X pouch, ileal reservoir [S or J]); diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) 44386 Endoscopic evaluation of small intestinal pouch (for example Kock X pouch, ileal reservoir [S or J]); with biopsy, single or multiple 44388 Colonoscopy through stoma; diagnostic, including collection of X Effective January 1, 2018 9
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) specimen(s) by brushing or washing, when performed (separate procedure) 44389 Colonoscopy through stoma; with biopsy, single or multiple X 44390 Colonoscopy through stoma; with removal of foreign body(s) X 44391 Colonoscopy through stoma; with control of bleeding, any method X 44392 Colonoscopy through stoma; with removal of tumor(s), polyp(s) or other X lesion(s) by hot biopsy forceps 44394 Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other X lesion(s) by snare technique 44401 Colonoscopy through stoma; with ablation of tumor(s), polyp(s), or other X lesion(s) (includes pre-and post-dilation and guide wire passage, when performed) 44402 Colonoscopy through stoma; with endoscopic stent placement (including X pre- and post-dilation and guide wire passage, when performed) 44403 Colonoscopy through stoma; with endoscopic mucosal resection X 44404 Colonoscopy through stoma; with directed submucosal injection(s), any X substance 44405 Colonoscopy through stoma; with transendoscopic balloon dilation X 44406 Colonoscopy through stoma; with endoscopic ultrasound examination, X limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures 44407 Colonoscopy through stoma; with transendoscopic ultrasound guided X intramural or transmural fine needle aspiration/biopsy(s), includes endoscopic ultrasound examination limited to the sigmoid, descending, transverse, or ascending colon and cecum and adjacent structures 44408 Colonoscopy through stoma; with decompression (for pathologic X distention) (for example volvulus, megacolon), including placement of decompression tube, when performed 45300 Proctosigmoidoscopy, rigid; diagnostic, with or without collection of X specimen(s) by brushing or washing (separate procedure) 45303 Proctosigmoidoscopy, rigid; with dilation, (for example, balloon, guide X wire, bougie) 45305 Proctosigmoidoscopy, rigid; with biopsy, single or multiple X 45307 Proctosigmoidoscopy, rigid; with removal of foreign body X 45308 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp or other X lesion by hot biopsy forceps or bipolar cautery 45309 Proctosigmoidoscopy, rigid; with removal of single tumor, polyp or other X lesion by snare technique 45315 Proctosigmoidoscopy, rigid; with removal of multiple tumors, polyps or X other lesions by hot biopsy forceps, bipolar cautery or snare technique 45317 Proctosigmoidoscopy, rigid; with control of bleeding, (for example, X injection, bipolar cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) 45320 Proctosigmoidoscopy, rigid; with ablation of tumor(s), polyp(s) or other X lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique (for example, laser) 45321 Proctosigmoidoscopy, rigid; with decompression of volvulus X 45327 Proctosigmoidoscopy, rigid; with transendoscopic stent placement X (includes predilation) 45330 Sigmoidoscopy, flexible; diagnostic, including collection of specimen(s) X by brushing or washing, when performed (separate procedure) 45331 Sigmoidoscopy, flexible; with biopsy, single or multiple X 45332 Sigmoidoscopy, flexible; with removal of foreign body(s) X 45333 Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s) or other X lesion(s) by hot biopsy forceps 45334 Sigmoidoscopy, flexible; with control of bleeding, any method X 45335 Sigmoidoscopy, flexible; with direct submucosal injection(s), any X
Effective January 1, 2018 10
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) substance 45337 Sigmoidoscopy, flexible; with decompression (for pathologic distention) X (for example volvulus, megacolon),including placement of decompression tube, when performed 45338 Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s) or other X lesion(s) by snare technique 45346 Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other X lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) 45340 Sigmoidoscopy, flexible; with transendoscopic balloon dilation X 45341 Sigmoidoscopy, flexible; with endoscopic ultrasound examination X 45342 Sigmoidoscopy, flexible; with transendoscopic ultrasound guided X intramural or transmural fine needle aspiration/biopsy(s) 45346 Sigmoidoscopy, flexible; with ablation of tumor(s), polyp(s), or other X lesion(s) (includes pre- and post-dilation and guide wire passage, when performed)
45347 Sigmoidoscopy, flexible; with placement of endoscopic stent (includes X pre- and post-dilation and guide wire passage, when performed) 45349 Sigmoidoscopy, flexible; with endoscopic mucosal resection X 45350 Sigmoidoscopy, flexible; with band ligation(s) (for example hemorrhoids) X 45378 Colonoscopy, flexible, proximal to splenic flexure; diagnostic, including X collection of specimen(s) by brushing or washing, when performed (separate procedure) 45379 Colonoscopy, flexible, with removal of foreign body(s) X 45380 Colonoscopy, flexible, with biopsy, single or multiple X 45381 Colonoscopy, flexible, with directed submucosal injection(s), any X subatance 45382 Colonoscopy, flexible, with control of bleeding, any method X 45384 Colonoscopy, flexible, with removal of tumor(s), polyp(s) or other X lesion(s) by hot biopsy forceps 45385 Colonoscopy, flexible, with removal of tumor(s), polyp(s) or other X lesion(s) by snare technique 45386 Colonoscopy, flexible, with transendoscopic balloon dilation X 45388 Colonoscopy through stoma; diagnostic, including collection of X specimen(s) by brushing or washing, when performed (separate procedure) 45389 Colonoscopy, flexible; with endoscopic stent placement (includes pre- X and post-dilation and guide wire passage, when performed) 45390 Colonoscopy, flexible; with endoscopic mucosal resection X 45391 Colonoscopy, flexible, with endoscopic ultrasound examination limited to X the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures. 45392 Colonoscopy, flexible, with transendoscopic ultrasound guided X intramural or transmural fine needle aspiration/biopsy(s)includes endoscopic ultrasound examination limited to the rectum, sigmoid, descending, transverse, or ascending colon and cecum, and adjacent structures. 45393 Colonoscopy, flexible; with decompression (for pathologic distention) X (for example volvulus, megacolon), including placement of decompression tube, when performed 45398 Colonoscopy, flexible; with band ligation(s) (for example hemorrhoids) X 46600 Anoscopy; diagnostic, including collection of specimen(s) by brushing or X washing, when performed (separate procedure) 46601 Anoscopy; diagnostic, with high-resolution magnification (HRA) (for X example colposcope, operating microscope) and chemical agent enhancement, including collection of specimen(s) by brushing or Effective January 1, 2018 11
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) washing, when performed 46604 Anoscopy; with dilation, (for example, balloon, guide wire, bougie) X 46606 Anoscopy; with biopsy, single or multiple X 46607 Anoscopy; with high-resolution magnification (HRA) (for example X colposcope, operating microscope) and chemical agent enhancement, with biopsy, single or multiple 46608 Anoscopy; with removal of foreign body X 46610 Anoscopy; with removal of single tumor, polyp, or other lesion by hot X biopsy forceps or bipolar cautery 46611 Anoscopy; with removal of single tumor, polyp, or other lesion by snare X technique 46612 Anoscopy; with removal of multiple tumors, polyps or other lesions by X hot biopsy forceps, bipolar cautery or snare technique 46614 Anoscopy; with control of bleeding (for example, injection, bipolar X cautery, unipolar cautery, laser, heater probe, stapler, plasma coagulator) 46615 Anoscopy; with ablation of tumor(s), polyp(s), or other lesion(s) not X amenable to removal by hot biopsy forceps, bipolar cautery or snare technique 47550 Biliary endoscopy, intraoperative (choledochoscopy) (list separately in X addition to code for primary procedure) 47552 Biliary endoscopy, percutaneous via T-tube or other tract; diagnostic, X with or without collection of specimen(s) by brushing and/or washing (separate procedure) 47553 Biliary endoscopy, percutaneous via T-tube or other tract; with biopsy, X single or multiple 47554 Biliary endoscopy, percutaneous via T-tube or other tract; with removal X of calculus/calculi 47555 Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of X biliary duct stricture(s) without stent 47556 Biliary endoscopy, percutaneous via T-tube or other tract; with dilation of X biliary duct stricture(s) with stent 49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or X without collection of specimen(s) by brushing or washing (separate procedure) 49321 Laparoscopy, surgical; with biopsy (single or multiple) X 49322 Laparoscopy, surgical; with aspiration of cavity or cyst (for example, X ovarian cyst) (single or multiple) 49323 Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity X 49327 Laparoscopy, surgical; with placement of interstitial device(s) for X radiation therapy guidance (for example 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 X 50551 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography, exclusive of radiologic service 50553 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography; with ureteral catheterization, with or without dilation of ureter 50555 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography; with biopsy 50557 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50561 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography, exclusive of Effective January 1, 2018 12
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) radiologic service; with removal of foreign body or calculus 50562 Renal endoscopy through established nephrostomy or pyelostomy, with X or without irrigation, installation or ureteropyelography, exclusive of radiologic service; with resection of tumor 50570 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation or ureteropyelography, exclusive of radiologic service 50572 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50574 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation or ureteropyelography, exclusive of radiologic service; with biopsy 50575 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation 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) 50576 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50580 Renal endoscopy through nephrotomy or pyelotomy, with or without X irrigation, installation or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 50945 Laparoscopy, surgical; ureterolithotomy X 50947 Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and X ureteral stent placement 50948 Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and X ureteral stent placement 50949 Unlisted laparoscopy procedure, ureter X 50951 Ureteral endoscopy through established ureterostomy, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service 50953 Ureteral endoscopy through established ureterostomy, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50955 Ureteral endoscopy through established ureterostomy, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service; with biopsy 50957 Ureteral endoscopy through established ureterostomy, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50961 Ureteral endoscopy through established ureterostomy, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 50970 Ureteral endoscopy with ureterotomy, with or without irrigation, X instillation or ureteropyelography, exclusive of radiologic service 50972 Ureteral endoscopy with ureterotomy, with or without irrigation, X instillation or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50974 Ureteral endoscopy with ureterotomy, with or without irrigation, X instillation or ureteropyelography, exclusive of radiologic service; with biopsy 50976 Ureteral endoscopy with ureterotomy, with or without irrigation, X instillation or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50980 Ureteral endoscopy with ureterotomy, with or without irrigation, X instillation or ureteropyelography, exclusive of radiologic service; with Effective January 1, 2018 13
Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) removal of foreign body or calculus 52000 Cystourethroscopy (separate procedure) X 52001 Cystourethroscopy with irrigation and evacuation of multiple obstructing X clots 52005 Cystourethroscopy, with ureteral catheterization, with or without X irrigation, instillation or ureteropyelography, exclusive of radiologic service 52007 Cystourethroscopy, with ureteral catheterization, with or without X irrigation, 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 X irrigation, instillation or duct radiology, exclusive of radiologic service 52204 Cystourethroscopy, with biopsy X 52250 Cystourethroscopy and radiotracer with or without biopsy or fulguration X 52282 Cystourethroscopy, with insertion of urethral stent X 52327 Cystourethroscopy (including ureteral catheterization); with subureteric X injection of implant material 52330 Cystourethroscopy (including ureteral catheterization); with X manipulation, without removal of ureteral calculus 52351 Cystourethroscopy with ureteroscopy and/or pyeloscopy; diagnostic X 52352 Cystourethroscopy with ureteroscopy and/or pyeloscopy; with removal X or manipulation of calculus (ureteral catheterization is included) 52353 Cystourethroscopy with ureteroscopy and/or pyeloscopy; with lithotripsy X (ureteral catherization is included) 52354 Cystourethroscopy with ureteroscopy and/or pyeloscopy; with biopsy X and/or fulguration of lesion 52355 Cystourethroscopy with ureteroscopy and/or pyeloscopy; with resection X of ureteral or renal pelvic tumor 52356 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy X including insertion of indwelling ureteral stent (for example Gibbons or double-J type) 52400 Cystourethroscopy with incision, fulguration or resection of cingenital X posterior urethral valves, or congenital obstructive hypertrophic mucosal folds 52402 Cystourethroscopy with transurethral resection or incision of ejaculatory X ducts 52441 Cystourethroscopy, with insertion of permanent adjustable transprostatic X implant; single implant 52442 Cystourethroscopy, with insertion of permanent adjustable transprostatic X implant; each additional permanent adjustable transprostatic implant (List separately in addition to code for primary procedure 54690 Laporoscopy, surgical; orchiectomy X 54692 Laporoscopy, surgical; orchiopexy for intra-abdominal testis X 57452 Colposcopy of the cervix including upper/adjacent vagina X 57454 Colposcopy of the cervix including upper/adjacent vagina;with biopsy(s) X of the cervix and endocervical curettage 57455 Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) X of the cervix 57456 Colposcopy of the cervix including upper/adjacent vagina; with X endocervical curettage 57460 Colposcopy of the cervix including upper/adjacent vagina; with loop X electrode biopsy(s) of the cervix 57461 Colposcopy of the cervix including upper/adjacent vagina; with loop X electrode conization of the cervix 58555 Hysteroscopy, diagnostic (separate procedure) X 58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or X polypectomy, with or without D & C
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Endoscopy Matrix CPT Description of Endoscopy Diagnostic Therapeutic Code (Surgical) 58559 Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method) X 58560 Hysteroscopy, surgical; with division of resection of intrauterine septum X (any method) 58561 Hysteroscopy, surgical; with removal of leiomyomata X 58562 Hysteroscopy, surgical; with removal of impacted foreign body X 58563 Hysteroscopy, surgical; with endometrial ablation (for example X endometrial resection, electrosurgical ablation, thermoablation) 58565 Hysteroscopy, surgical; with bilateral fallopian tube cannulation to X induce occlusion by placement of permanent implants 58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, X ovariolysis) (separate procedure) 58661 Laparoscopy, surgical; with removal of adnexal structures (partial or X total oophorectomy and/or salpingectomy) 58662 Laparoscopy, surgical; with fulguration or excision of lesions of the X ovary, pelvic viscera or peritoneal surface by any method 60650 Laparoscopy, surgical, with adrenalectomy, partial or complete, or X exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal G0104 Colorectal cancer screening; flexible sigmoidoscopy X G0105 Colorectal cancer screening; colonoscopy on individual at high risk X G0121 Colorectal cancer screening; colonoscopy on individual not meeting X criteria for high risk S0601 Screening proctoscopy X
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