Ipo) List for Cy 2021 (N=266)

TABLE 31: PROPOSED MUSCULOSKELETAL-RELATED SERVICE REMOVALS FROM

THE INPATIENT ONLY (IPO) LIST FOR CY 2021 (N=266)

CY CY 2020 Long Descriptor Related Proposed Proposed 2020 Services CY 2021 CY 2021 CPT OPPS OPPS APC Code Status Assignment Indicator 0095T Removal of total disc arthroplasty 22856 N/A (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) 0098T Revision including replacement 22858 N/A of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in addition to code for primary procedure) 0163T Total disc arthroplasty (artificial 22858 N/A disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to code for primary procedure) 0164T Removal of total disc 22856 N/A arthroplasty, (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) 0165T Revision including replacement 22858 N/A of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list separately in addition to code for primary procedure) 0202T Posterior vertebral joint(s) 63030 J1 5115 arthroplasty (for example, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when performed, including fluoroscopy, single level, lumbar spine 0219T Placement of a posterior 63040 J1 5115 intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical 0220T Placement of a posterior 63046 J1 5115 intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; thoracic 20661 Application of halo, including 20660 Q1 5113 removal; cranial 20664 Application of halo, including 20660 Q1 5113 removal, cranial, 6 or more pins placed, for thin skull osteology (for example, pediatric patients, hydrocephalus, osteogenesis imperfecta) 20802 Replantation, arm (includes 24545 J1 5116 surgical neck of humerus through elbow joint), complete amputation 20805 Replantation, forearm (includes 24545 J1 5116 radius and ulna to radial carpal joint), complete amputation 20808 Replantation, hand (includes 24545 J1 5116 hand through metacarpophalangeal joints), complete amputation 20816 Replantation, digit, excluding 24371 J1 5114 thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), complete amputation 20824 Replantation, thumb (includes 24371 J1 5114 carpometacarpal joint to mp joint), complete amputation 20827 Replantation, thumb (includes 24371 J1 5114 distal tip to mp joint), complete amputation 20838 Replantation, foot, complete 24371 J1 5116 amputation 20955 Bone graft with microvascular 27634 J1 5114 anastomosis; fibula 20956 Bone graft with microvascular 27634 J1 5114 anastomosis; iliac crest 20957 Bone graft with microvascular 27634 J1 5114 anastomosis; metatarsal 20962 Bone graft with microvascular 27634 J1 5114 anastomosis; other than fibula, iliac crest, or metatarsal 20969 Free osteocutaneous flap with 27634 J1 5114 microvascular anastomosis; other than iliac crest, metatarsal, or great toe 20970 Free osteocutaneous flap with 27634 J1 5114 microvascular anastomosis; iliac crest 21045 Excision of malignant tumor of 21044 J1 5165 mandible; radical resection 21141 Reconstruction midface, lefort i; 21150 J1 5165 single piece, segment movement in any direction (for example, for long face syndrome), without bone graft 21142 Reconstruction midface, lefort i; 21150 J1 5165 2 pieces, segment movement in any direction, without bone graft 21143 Reconstruction midface, lefort i; 21150 J1 5165 3 or more pieces, segment movement in any direction, without bone graft 21145 Reconstruction midface, LeFort I; 21150 J1 5165 single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts) 21146 Reconstruction midface, LeFort I; 21150 J1 5165 single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts) 21147 Reconstruction midface, LeFort I; 21150 J1 5165 single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts) 21151 Reconstruction midface, LeFort 21150 J1 5165 II; any direction, requiring bone grafts (includes obtaining autografts) 21154 Reconstruction of midface bones 21150 J1 5165 with bone graft

Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I 21155 Reconstruction midface, LeFort 21150 J1 5165 III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I 21159 Reconstruction midface, LeFort 21150 J1 5165 III (extra and intracranial) with forehead advancement (for example, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I 21160 Reconstruction midface, LeFort 21150 J1 5165 III (extra and intracranial) with forehead advancement (for example, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I 21179 Reconstruction, entire or majority 21175 J1 5165 of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material) 21180 Reconstruction, entire or majority 21175 J1 5165 of forehead and/or supraorbital rims; with autograft (includes obtaining grafts) 21182 Reconstruction of orbital walls, 21175 J1 5165 rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (for example, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm 21183 Reconstruction of orbital walls, 21175 J1 5165 rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (for example, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cm 21184 Reconstruction of orbital walls, 21175 J1 5165 rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (for example, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cm 21188 Reconstruction midface, 21175 J1 5165 osteotomies (other than lefort type) and bone grafts (includes obtaining autografts) 21194 Reconstruction of mandibular 21175 J1 5165 rami, horizontal, vertical, c, or l osteotomy; with bone graft (includes obtaining graft) 21196 Reconstruction of mandibular 21175 J1 5165 rami and/or body, sagittal split; with internal rigid fixation 21247 Reconstruction of mandibular 21175 J1 5165 condyle with bone and cartilage autografts (includes obtaining grafts) (for example, for hemifacial microsomia) 21255 Reconstruction of zygomatic arch 21175 J1 5165 and glenoid fossa with bone and cartilage (includes obtaining autografts) 21268 Orbital repositioning, periorbital 21172 J1 5165 osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach 21343 Open treatment of depressed 21346 J1 5165 frontal sinus fracture 21344 Open treatment of complicated 21346 J1 5165 (for example, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches 21347 Open treatment of nasomaxillary 21346 J1 5165 complex fracture (lefort ii type); requiring multiple open approaches 21348 Open treatment of nasomaxillary 21346 J1 5165 complex fracture (lefort ii type); with bone grafting (includes obtaining graft) 21366 Open treatment of complicated 21365 J1 5165 (for example, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft) 21422 Open treatment of palatal or 21445 J1 5165 maxillary fracture (lefort i type); 21423 Open treatment of palatal or 21445 J1 5165 maxillary fracture (lefort i type); complicated (comminuted or involving cranial nerve foramina), multiple approaches 21431 Closed treatment of craniofacial 21445 J1 5165 separation (lefort iii type) using interdental wire fixation of denture or splint 21432 Open treatment of craniofacial 21445 J1 5165 separation (lefort iii type); with wiring and/or internal fixation 21433 Open treatment of craniofacial 21445 J1 5165 separation (lefort iii type); complicated (for example, comminuted or involving cranial nerve foramina), multiple surgical approaches 21435 Open treatment of craniofacial 21445 J1 5165 separation (lefort iii type); complicated, utilizing internal and/or external fixation techniques (for example, head cap, halo device, and/or intermaxillary fixation) 21436 Open treatment of craniofacial 21445 J1 5165 separation (lefort iii type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft) 21510 Incision, deep, with opening of 21502 J1 5114 bone cortex (for example, for osteomyelitis or bone abscess), thorax 21602 Excision of chest wall tumor 21601 J1 5114 involving rib(s), with plastic reconstruction; without mediastinal lymphadenectomy 21603 Excision of chest wall tumor 21601 J1 5114 involving rib(s), with plastic reconstruction; with mediastinal lymphadenectomy 21615 Excision first and/or cervical rib; 21601 J1 5114 21616 Excision first and/or cervical rib; 21601 J1 5114 with sympathectomy 21620 Ostectomy of sternum, partial 21601 J1 5114 21627 Sternal debridement 21601 J1 5114 21630 Radical resection of sternum; 21601 J1 5114 21632 Radical resection of sternum; 21601 J1 5114 with mediastinal lymphadenectomy 21705 Division of scalenus anticus; with 21700 J1 5114 resection of cervical rib 21740 Reconstructive repair of pectus 21601 J1 5114 excavatum or carinatum; open 21750 Closure of median sternotomy 21601 J1 5114 separation with or without debridement (separate procedure) 21825 Open treatment of sternum 21813 J1 5114 fracture with or without skeletal fixation 22010 Incision and drainage, open, of 22100 J1 5114 deep abscess (subfascial), posterior spine; cervical, thoracic, or cervicothoracic 22015 Incision and drainage, open, of 22102 J1 5114 deep abscess (subfascial), posterior spine; lumbar, sacral, or lumbosacral 22110 Partial excision of vertebral body, 22100 J1 5114 for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervical 22112 Partial excision of vertebral body, 22102 J1 5114 for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracic 22114 Partial excision of vertebral body, 22102 J1 5114 for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbar 22116 Partial excision of vertebral body, 22100 N/A N/A for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure) 22206 Osteotomy of spine, posterior or 22102 J1 5114 posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); thoracic 22207 Osteotomy of spine, posterior or 22102 J1 5114 posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); lumbar 22208 Osteotomy of spine, posterior or 22103 N/A posterolateral approach, 3 columns, 1 vertebral segment (for example, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in addition to code for primary procedure) 22210 Osteotomy of spine, posterior or 22100 J1 5114 posterolateral approach, 1 vertebral segment; cervical 22212 Osteotomy of spine, posterior or 22102 J1 5114 posterolateral approach, 1 vertebral segment; thoracic 22214 Osteotomy of spine, posterior or 22102 J1 5114 posterolateral approach, 1 vertebral segment; lumbar 22216 Osteotomy of spine, posterior or 22103 N/A posterolateral approach, 1 vertebral segment; each additional vertebral segment (list separately in addition to primary procedure) 22220 Osteotomy of spine, including 22100 J1 5114 discectomy, anterior approach, single vertebral segment; cervical 22222 Osteotomy of spine, including 22102 J1 5114 discectomy, anterior approach, single vertebral segment; thoracic 22224 Osteotomy of spine, including 22102 J1 5114 discectomy, anterior approach, single vertebral segment; lumbar 22226 Osteotomy of spine, including 22103 N/A discectomy, anterior approach, single vertebral segment; each additional vertebral segment (list separately in addition to code for primary procedure) 22318 Open treatment and/or reduction 22551 J1 5115 of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without grafting 22319 Open treatment and/or reduction 22551 J1 5115 of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with grafting 22325 Open treatment and/or reduction 22554 J1 5115 of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbar 22326 Open treatment and/or reduction 22554 J1 5115 of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervical 22327 Open treatment and/or reduction 22102 J1 5115 of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracic 22328 Open treatment and/or reduction 22103 N/A of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; each additional fractured vertebra or dislocated segment (list separately in addition to code for primary procedure) 22532 Arthrodesis, lateral extracavitary 22554 J1 5116 technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic 22533 Arthrodesis, lateral extracavitary 22554 J1 5116 technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar 22534 Arthrodesis, lateral extracavitary 22103 N/A technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (list separately in addition to code for primary procedure) 22548 Arthrodesis, anterior transoral or 22551 J1 5116 extraoral technique, clivus-c1-c2 (atlas-axis), with or without excision of odontoid process 22556 Arthrodesis, anterior interbody 22554 J1 5116 technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic 22558 Arthrodesis, anterior interbody 22554 J1 5116 technique, including minimal discectomy to prepare interspace (other than for decompression); lumbar 22586 Arthrodesis, pre-sacral interbody 22554 J1 5116 technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, l5-s1 interspace 22590 Arthrodesis, posterior technique, 22551 J1 5116 craniocervical (occiput-c2) 22595 Arthrodesis, posterior technique, 22551 J1 5116 atlas-axis (c1-c2) 22600 Arthrodesis, posterior or 22551 J1 5116 posterolateral technique, single level; cervical below c2 segment 22610 Arthrodesis, posterior or 22612 J1 5116 posterolateral technique, single level; thoracic (with lateral transverse technique, when performed) 22630 Arthrodesis, posterior interbody 22612 J1 5116 technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; lumbar 22632 Arthrodesis, posterior interbody 22585 N/A technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace (list separately in addition to code for primary procedure) 22800 Arthrodesis, posterior, for spinal 22612 J1 5116 deformity, with or without cast; up to 6 vertebral segments 22802 Arthrodesis, posterior, for spinal 22612 J1 5116 deformity, with or without cast; 7 to 12 vertebral segments 22804 Arthrodesis, posterior, for spinal 22612 J1 5116 deformity, with or without cast; 13 or more vertebral segments 22808 Arthrodesis, anterior, for spinal 22612 J1 5116 deformity, with or without cast; 2 to 3 vertebral segments 22810 Arthrodesis, anterior, for spinal 22612 J1 5116 deformity, with or without cast; 4 to 7 vertebral segments 22812 Arthrodesis, anterior, for spinal 22612 J1 5116 deformity, with or without cast; 8 or more vertebral segments 22818 Kyphectomy, circumferential 22612 J1 5116 exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segments 22819 Kyphectomy, circumferential 22612 J1 5116 exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segments 22830 Exploration of spinal fusion 22612 J1 5115 22841 Internal spinal fixation by wiring 22840 N/A of spinous processes (list separately in addition to code for primary procedure) 22843 Posterior segmental 22840 N/A instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral segments (list separately in addition to code for primary procedure) 22844 Posterior segmental 22840 N/A instrumentation (for example, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more vertebral segments (list separately in addition to code for primary procedure) 22846 Anterior instrumentation; 4 to 7 22840 N/A vertebral segments (list separately in addition to code for primary procedure) 22847 Anterior instrumentation; 8 or 22840 N/A more vertebral segments (list separately in addition to code for primary procedure) 22848 Pelvic fixation (attachment of 22840 N/A caudal end of instrumentation to pelvic bony structures) other than sacrum (list separately in addition to code for primary procedure) 22849 Reinsertion of spinal fixation 22612 J1 5116 device 22850 Removal of posterior 22612 J1 5115 nonsegmental instrumentation (for example, harrington rod) 22852 Removal of posterior segmental 22612 J1 5115 instrumentation 22855 Removal of anterior 22612 J1 5115 instrumentation 22857 Total disc arthroplasty (artificial 22856 J1 5116 disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbar 22861 Revision including replacement 22856 J1 5116 of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervical 22862 Revision including replacement 22856 J1 5116 of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar 22864 Removal of total disc arthroplasty 22856 J1 5115 (artificial disc), anterior approach, single interspace; cervical 22865 Removal of total disc arthroplasty 22856 J1 5115 (artificial disc), anterior approach, single interspace; cervical 23200 Radical resection of tumor; 23155 J1 5114 clavicle 23210 Radical resection of tumor; 23155 J1 5114 scapula 23220 Radical resection of tumor, 23155 J1 5114 proximal humerus 23335 Removal of prosthesis, includes 23334 J1 5073 debridement and synovectomy when performed; humeral and glenoid components (for example, total shoulder) 23472 Arthroplasty, glenohumeral joint; 23470 J1 5115 total shoulder (glenoid and proximal humeral replacement (for example, total shoulder)) 23474 Revision of total shoulder 23473 J1 5115 arthroplasty, including allograft when performed; humeral and glenoid component 23900 Interthoracoscapular amputation 23680 J1 5115 (forequarter) 23920 Disarticulation of shoulder; 23680 J1 5115 24900 Amputation, arm through 23680 J1 5115 humerus; with primary closure 24920 Amputation, arm through 23680 J1 5115 humerus; open, circular (guillotine) 24930 Amputation, arm through 24925 J1 5114 humerus; re-amputation 24931 Amputation, arm through 23680 J1 5115 humerus; with implant 24940 Cineplasty, upper extremity, 23680 J1 5115 complete procedure 25900 Amputation, forearm, through 27709 J1 5115 radius and ulna; 25905 Amputation, forearm, through 27709 J1 5115 radius and ulna; open, circular (guillotine) 25915 Krukenberg procedure 27709 J1 5114 25920 Disarticulation through wrist; 25922 J1 5114 25924 Disarticulation through wrist; re- 25922 J1 5114 amputation 25927 Transmetacarpal amputation; 25922 J1 5113 26551 Transfer, toe-to-hand with 20973 J1 5114 microvascular anastomosis; great toe wrap-around with bone graft 26553 Transfer, toe-to-hand with 20973 J1 5114 microvascular anastomosis; other than great toe, single 26554 Transfer, toe-to-hand with 20973 J1 5114 microvascular anastomosis; other than great toe, double 26556 Transfer, free toe joint, with 20973 J1 5114 microvascular anastomosis 26992 Incision, bone cortex, pelvis 26990 J1 5114 and/or hip joint (for example, osteomyelitis or bone abscess) 27005 Tenotomy, hip flexor(s), open 27006 J1 5114 (separate procedure) 27025 Fasciotomy, hip or thigh, any 27027 J1 5114 type 27030 Arthrotomy, hip, with drainage 27033 J1 5114 (for example, infection) 27036 Capsulectomy or capsulotomy, 27033 J1 5114 hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, sartorius, iliopsoas) 27054 Arthrotomy with synovectomy, 27052 J1 5113 hip joint 27070 Partial excision, wing of ilium, 27065 J1 5114 symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (for example, osteomyelitis or bone abscess); superficial 27071 Partial excision, wing of ilium, 27065 J1 5114 symphysis pubis, or greater trochanter of femur, (craterization, saucerization) (for example, osteomyelitis or bone abscess); deep (subfascial or intramuscular) 27075 Radical resection of tumor; wing 27067 J1 5114 of ilium, 1 pubic or ischial ramus or symphysis pubis 27076 Radical resection of tumor; ilium, 27067 J1 5114 including acetabulum, both pubic rami, or ischium and acetabulum 27077 Radical resection of tumor; 27067 J1 5115 innominate bone, total 27078 Radical resection of tumor; 27067 J1 5115 ischial tuberosity and greater trochanter of femur 27090 Removal of hip prosthesis; 20680 J1 5073 (separate procedure) 27091 Removal of hip prosthesis; 20680 J1 5073 complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacer 27120 Acetabuloplasty; (for example, 27067 J1 5115 whitman, colonna, haygroves, or cup type) 27122 Acetabuloplasty; resection, 27067 J1 5115 femoral head (for example, girdlestone procedure) 27125 Hemiarthroplasty, hip, partial (for 27130 J1 5115 example, femoral stem prosthesis, bipolar arthroplasty) 27132 Conversion of previous hip 27130 J1 5115 surgery to total hip arthroplasty, with or without autograft or allograft 27134 Revision of total hip arthroplasty; 27130 J1 5115 both components, with or without autograft or allograft 27137 Revision of total hip arthroplasty; 27130 J1 5115 acetabular component only, with or without autograft or allograft 27138 Revision of total hip arthroplasty; 27130 J1 5115 femoral component only, with or without allograft 27140 Osteotomy and transfer of greater 27130 J1 5115 trochanter of femur (separate procedure) 27146 Osteotomy, iliac, acetabular or 27179 J1 5114 innominate bone; 27147 Osteotomy, iliac, acetabular or 27179 J1 5114 innominate bone; with open reduction of hip 27151 Osteotomy, iliac, acetabular or 27179 J1 5114 innominate bone; with femoral osteotomy 27156 Osteotomy, iliac, acetabular or 27179 J1 5114 innominate bone; with femoral osteotomy and with open reduction of hip 27158 Osteotomy, pelvis, bilateral (for 27179 J1 5114 example, congenital malformation) 27161 Osteotomy, femoral neck 27179 J1 5114 (separate procedure) 27165 Osteotomy, intertrochanteric or 27179 J1 5114 subtrochanteric including internal or external fixation and/or cast 27170 Bone graft, femoral head, neck, 27179 J1 5114 intertrochanteric or subtrochanteric area (includes obtaining bone graft) 27175 Treatment of slipped femoral 27179 J1 5114 epiphysis; by traction, without reduction 27176 Treatment of slipped femoral 27179 J1 5115 epiphysis; by single or multiple pinning, in situ 27177 Open treatment of slipped 27179 J1 5114 femoral epiphysis; single or multiple pinning or bone graft (includes obtaining graft) 27178 Open treatment of slipped 27179 J1 5114 femoral epiphysis; closed manipulation with single or multiple pinning 27181 Open treatment of slipped 27179 J1 5114 femoral epiphysis; osteotomy and internal fixation 27185 Epiphyseal arrest by 27179 J1 5114 epiphysiodesis or stapling, greater trochanter of femur 27187 Prophylactic treatment (nailing, 27235 J1 5114 pinning, plating or wiring) with or without methylmethacrylate, femoral neck and proximal femur 27222 Closed treatment of acetabulum 27220 J1 5111 (hip socket) fracture(s); with manipulation, with or without skeletal traction 27226 Open treatment of posterior or 27235 J1 5114 anterior acetabular wall fracture, with internal fixation 27227 Open treatment of acetabular 27235 J1 5114 fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across the acetabulum, with internal fixation 27228 Open treatment of acetabular 27235 J1 5114 fracture(s) involving anterior and posterior (two) columns, includes t-fracture and both column fracture with complete articular detachment, or single column or transverse fracture with associated acetabular wall fracture, with internal fixation 27232 Closed treatment of femoral 27238 J1 5112 fracture, proximal end, neck; with manipulation, with or without skeletal traction 27236 Open treatment of femoral 27235 J1 5114 fracture, proximal end, neck, internal fixation or prosthetic replacement 27240 Closed treatment of 27238 J1 5112 intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or without skin or skeletal traction 27244 Treatment of intertrochanteric, 27235 J1 5114 peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without cerclage 27245 Treatment of intertrochanteric, 27235 J1 5114 peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without interlocking screws and/or cerclage 27248 Open treatment of greater 27235 J1 5114 trochanteric fracture, includes internal fixation, when performed 27253 Open treatment of hip 27235 J1 5113 dislocation, traumatic, without internal fixation 27254 Open treatment of hip 27235 J1 5113 dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external fixation 27258 Open treatment of spontaneous 27235 J1 5113 hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); 27259 Open treatment of spontaneous 27235 J1 5113 hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft shortening 27268 Closed treatment of femoral 27238 J1 5113 fracture, proximal end, head; with manipulation 27269 Open treatment of femoral 27238 J1 5112 fracture, proximal end, head, includes internal fixation, when performed 27280 Arthrodesis, open, sacroiliac 27279 J1 5116 joint, including obtaining bone graft, including instrumentation, when performed 27282 Arthrodesis, symphysis pubis 28730 J1 5115 (including obtaining graft) 27284 Arthrodesis, hip joint (including 27279 J1 5116 obtaining graft); 27286 Arthrodesis, hip joint (including 27279 J1 5116 obtaining graft); with subtrochanteric osteotomy 27290 Interpelviabdominal amputation 27279 J1 5116 (hindquarter amputation) 27295 Detachment of hip joint 27279 J1 5116 27303 Incision, deep, with opening of 27305 J1 5114 bone cortex, femur or knee (for example, osteomyelitis or bone abscess) 27365 Radical resection of tumor, femur 27364 J1 5114 or knee 27445 Arthroplasty, knee, hinge 27447 J1 5115 prosthesis (for example, walldius type) 27448 Osteotomy, femur, shaft or 27485 J1 5114 supracondylar; without fixation 27450 Osteotomy, femur, shaft or 27485 J1 5114 supracondylar; with fixation 27454 Osteotomy, multiple, with 27485 J1 5114 realignment on intramedullary rod, femoral shaft (for example, sofield type procedure) 27455 Osteotomy, proximal tibia, 27485 J1 5114 including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); before epiphyseal closure 27457 Osteotomy, proximal tibia, 27485 J1 5114 including fibular excision or osteotomy (includes correction of genu varus [bowleg] or genu valgus [knock-knee]); after epiphyseal closure 27465 Osteoplasty, femur; shortening 27485 J1 5114 (excluding 64876) 27466 Osteoplasty, femur; lengthening 27485 J1 5114 27468 Osteoplasty, femur; combined, 27485 J1 5114 lengthening and shortening with femoral segment transfer 27470 Repair, nonunion or malunion, 27485 J1 5114 femur, distal to head and neck; without graft (for example, compression technique) 27472 Repair, nonunion or malunion, 27485 J1 5114 femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft) 27486 Repair, nonunion or malunion, 27477 J1 5115 femur, distal to head and neck; with iliac or other autogenous bone graft (includes obtaining graft) 27487 Revision of total knee 27477 J1 5115 arthroplasty, with or without allograft; femoral and entire tibial component 27488 Removal of prosthesis, including 27485 J1 5114 total knee prosthesis, methylmethacrylate with or without insertion of spacer, knee 27495 Prophylactic treatment (nailing, 27475 J1 5114 pinning, plating, or wiring) with or without methylmethacrylate, femur 27506 Open treatment of femoral shaft 27509 J1 5114 fracture, with or without external fixation, with insertion of intramedullary implant, with or without cerclage and/or locking screws 27507 Open treatment of femoral shaft 27509 J1 5114 fracture with plate/screws, with or without cerclage 27511 Open treatment of femoral 27509 J1 5114 supracondylar or transcondylar fracture without intercondylar extension, includes internal fixation, when performed 27513 Open treatment of femoral 27509 J1 5114 supracondylar or transcondylar fracture with intercondylar extension, includes internal fixation, when performed 27514 Open treatment of femoral 27509 J1 5114 fracture, distal end, medial or lateral condyle, includes internal fixation, when performed 27519 Open treatment of femoral 27509 J1 5114 fracture, distal end, medial or lateral condyle, includes internal fixation, when performed 27535 Open treatment of tibial fracture, 27532 J1 5114 proximal (plateau); unicondylar, includes internal fixation, when performed 27536 Open treatment of tibial fracture, 27532 J1 5114 proximal (plateau); bicondylar, with or without internal fixation 27540 Open treatment of intercondylar 27532 J1 5114 spine(s) and/or tuberosity fracture(s) of the knee, includes internal fixation, when performed 27556 Open treatment of knee 27532 J1 5114 dislocation, includes internal fixation, when performed; without primary ligamentous repair or augmentation/reconstruction 27557 Open treatment of knee 27532 J1 5114 dislocation, includes internal fixation, when performed; with primary ligamentous repair 27558 Open treatment of knee 27335 J1 5114 dislocation, includes internal fixation, when performed; with primary ligamentous repair 27580 Arthrodesis, knee, any technique 27594 J1 5115 27590 Amputation, thigh, through 27594 J1 5116 femur, any level; 27591 Amputation, thigh, through 27594 J1 5116 femur, any level; immediate fitting technique including first cast 27592 Amputation, thigh, through 27594 J1 5116 femur, any level; open, circular (guillotine) 27596 Amputation, thigh, through 27499 J1 5114 femur, any level; re-amputation 27598 Disarticulation at knee 27428 J1 5115 27645 Radical resection of tumor; tibia 27637 J1 5114 27646 Radical resection of tumor; fibula 27637 J1 5114 27702 Arthroplasty, ankle; with implant 27447 J1 5115 (total ankle) 27703 Arthroplasty, ankle; revision, 27447 J1 5115 total ankle 27712 Osteotomy; multiple, with 27709 J1 5115 realignment on intramedullary rod (for example, sofield type procedure) 27715 Osteoplasty, tibia and fibula, 27709 J1 5115 lengthening or shortening 27724 Repair of nonunion or malunion, 27722 J1 5114 tibia; with iliac or other autograft (includes obtaining graft) 27725 Repair of nonunion or malunion, 27722 J1 5114 tibia; by synostosis, with fibula, any method 27727 Repair of congenital 27722 J1 5114 pseudarthrosis, tibia 27880 Amputation, leg, through tibia 27884 J1 5116 and fibula; 27881 Amputation, leg, through tibia 27884 J1 5114 and fibula; with immediate fitting technique including application of first cast 27882 Amputation, leg, through tibia 27884 J1 5114 and fibula; open, circular (guillotine) 27886 Amputation, leg, through tibia 27884 J1 5114 and fibula; re-amputation 27888 Amputation, ankle, through 27884 J1 5115 malleoli of tibia and fibula (for example, syme, pirogoff type procedures), with plastic closure and resection of nerves 28800 Amputation, foot; midtarsal (for 28805 J1 5113 example, chopart type procedure) G0412 Open treatment of iliac spine(s), 27179 J1 5114 tuberosity avulsion, or iliac wing fracture(s), unilateral or bilateral for pelvic bone fracture patterns which do not disrupt the pelvic ring includes internal fixation, when performed G0414 Open treatment of anterior pelvic 27202 J1 5115 bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic symphysis and/or superior/inferior rami) G0415 Open treatment of posterior pelvic 27202 J1 5115 bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed (includes ilium, sacroiliac joint and/or sacrum)

TABLE 40. — PROPOSED ADDITIONS TO THE LIST OF ASC COVERED SURGICAL PROCEDURES FOR CY 2021 UNDER STANDARD REVIEW PROCESS

CY Proposed CY 2021 2021 ASC CPT/ CY 2021 Long Descriptor Payment HCPCS Indicator Code Implantation or replacement of carotid sinus baroreflex activation device; total G2 0266T system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and repositioning, when performed) Implantation or replacement of carotid sinus baroreflex activation device; pulse J8 0268T generator only (includes intra-operative interrogation, programming, and repositioning, when performed) Transcervical uterine fibroid(s) ablation with ultrasound guidance, G2 0404T radiofrequency Open treatment of complicated (e.g., comminuted or involving cranial nerve G2 21365 foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip J8 27130 arthroplasty), with or without autograft or allograft 27412 Autologous chondrocyte implantation, knee G2 57282 Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) G2 Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) G2 57283

57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex) G2 Revascularization, endovascular, open or percutaneous, any vessel(s); with G2 C9764 intravascular lithotripsy, includes angioplasty within the same vessel (s), when performed Revascularization, endovascular, open or percutaneous, any vessel (s); with J8 C9766 intravascular lithotripsy and atherectomy, includes angioplasty within the same vessel (s), when performed

TABLE 41. — PROPOSED ADDITIONS TO THE ASC-CPL UNDER SECOND ALTERNATIVE PROPOSAL CONSIDERED FOR CY 2021

CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Mastectomy, modified radical, including axillary lymph nodes, with or without 19307 G2 pectoralis minor muscle, but excluding pectoralis major muscle 20100 Exploration of penetrating wound (separate procedure); neck G2 20101 Exploration of penetrating wound (separate procedure); chest G2 20102 Exploration of penetrating wound (separate procedure); abdomen/flank/back G2 CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Application of cranial tongs, caliper, or stereotactic frame, including removal 20660 G2 (separate procedure)

Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy 21049 G2 and partial maxillectomy (eg, locally aggressive or destructive lesion[s])

Reconstruction superior-lateral orbital rim and lower forehead, advancement or 21172 G2 alteration, with or without grafts (includes obtaining autografts) Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, 21175 advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), G2 with or without grafts (includes obtaining autografts) Reconstruction of mandibular rami, horizontal, vertical, c, or l osteotomy; 21193 G2 without bone graft Reconstruction of mandibular rami and/or body, sagittal split; without internal 21195 J8 rigid fixation Reconstruction of orbit with osteotomies (extracranial) and with bone grafts 21256 G2 (includes obtaining autografts) (eg, micro-ophthalmia) Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined 21261 G2 intra- and extracranial approach Periorbital osteotomies for orbital hypertelorism, with bone grafts; with 21263 G2 forehead advancement Open treatment of nasomaxillary complex fracture (lefort ii type); with wiring 21346 G2 and/or local fixation Open treatment of complicated (eg, comminuted or involving cranial nerve 21365 foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; G2 with internal fixation and multiple surgical approaches Open treatment of orbital floor blowout fracture; transantral approach 21385 G2 (caldwell-luc type operation) 21386 Open treatment of orbital floor blowout fracture; periorbital approach G2 21387 Open treatment of orbital floor blowout fracture; combined approach G2 Open treatment of orbital floor blowout fracture; periorbital approach with 21395 G2 bone graft (includes obtaining graft) Open treatment of fracture of orbit, except blowout; with bone grafting 21408 G2 (includes obtaining graft) Open treatment of complicated mandibular fracture by multiple surgical 21470 approaches including internal fixation, interdental fixation, and/or wiring of J8 dentures or splints 21601 Excision of chest wall tumor including rib(s) G2 Reconstructive repair of pectus excavatum or carinatum; minimally invasive 21742 G2 approach (nuss procedure), without thoracoscopy Reconstructive repair of pectus excavatum or carinatum; minimally invasive 21743 G2 approach (nuss procedure), with thoracoscopy Partial excision of posterior vertebral component (eg, spinous process, lamina 22100 G2 or facet) for intrinsic bony lesion, single vertebral segment; cervical CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Partial excision of posterior vertebral component (eg, spinous process, lamina 22101 G2 or facet) for intrinsic bony lesion, single vertebral segment; thoracic 23470 Arthroplasty, glenohumeral joint; hemiarthroplasty J8 Revision of total shoulder arthroplasty, including allograft when performed; 23473 J8 humeral or glenoid component 24150 Radical resection of tumor, shaft or distal humerus G2 24935 Stump elongation, upper extremity G2 25170 Radical resection of tumor, radius or ulna G2 25909 Amputation, forearm, through radius and ulna; re-amputation G2 27006 Tenotomy, abductors and/or extensor(s) of hip, open (separate procedure) G2 Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus 27027 medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata G2 muscle), unilateral Decompression fasciotomy(ies), pelvic (buttock) compartment(s) (eg, gluteus 27057 medius-minimus, gluteus maximus, iliopsoas, and/or tensor fascia lata muscle) G2 with debridement of nonviable muscle, unilateral Arthroplasty, acetabular and proximal femoral prosthetic replacement (total 27130 J8 hip arthroplasty), with or without autograft or allograft Open treatment of slipped femoral epiphysis; osteoplasty of femoral neck 27179 G2 (heyman type procedure) 27235 Percutaneous skeletal fixation of femoral fracture, proximal end, neck G2 27412 Autologous chondrocyte implantation, knee G2 27477 Arrest, epiphyseal, any method (eg, epiphysiodesis); tibia and fibula, proximal J8 Arrest, hemiepiphyseal, distal femur or proximal tibia or fibula (eg, genu varus 27485 G2 or valgus) 27722 Repair of nonunion or malunion, tibia; with sliding graft J8 28360 Reconstruction, cleft foot G2 28805 Amputation, foot; transmetatarsal G2 Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for 29868 G2 meniscal insertion), medial or lateral 31241 Nasal/sinus endoscopy, surgical; with ligation of sphenopalatine artery G2 Nasal/sinus endoscopy, surgical, with orbital decompression; medial or 31292 G2 inferior wall Nasal/sinus endoscopy, surgical, with orbital decompression; medial and 31293 G2 inferior wall 31294 Nasal/sinus endoscopy, surgical, with optic nerve decompression G2 Laryngoplasty; with open reduction and fixation of (eg, plating) fracture, 31584 G2 includes tracheostomy, if performed 31587 Laryngoplasty, cricoid split, without graft placement G2 31600 Tracheostomy, planned (separate procedure); G2 31601 Tracheostomy, planned (separate procedure); younger than 2 years G2 31610 Tracheostomy, fenestration procedure with skin flaps G2 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 31660 J8 performed; with bronchial thermoplasty, 1 lobe CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when 31661 J8 performed; with bronchial thermoplasty, 2 or more lobes 31785 Excision of tracheal tumor or carcinoma; cervical G2 Tube thoracostomy, includes connection to drainage system (eg, water seal), 32551 G2 when performed, open (separate procedure) Instillation, via chest tube/catheter, agent for pleurodesis (eg, talc for recurrent 32560 G2 or persistent pneumothorax) Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic 32561 G2 agent for break up of multiloculated effusion); initial day Instillation(s), via chest tube/catheter, agent for fibrinolysis (eg, fibrinolytic 32562 G2 agent for break up of multiloculated effusion); subsequent day Thoracoscopy, diagnostic (separate procedure); lungs, pericardial sac, 32601 G2 mediastinal or pleural space, without biopsy 32604 Thoracoscopy, diagnostic (separate procedure); pericardial sac, with biopsy G2 32606 Thoracoscopy, diagnostic (separate procedure); mediastinal space, with biopsy G2 Thoracoscopy; with diagnostic biopsy(ies) of lung infiltrate(s) (eg, wedge, 32607 G2 incisional), unilateral Thoracoscopy; with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (eg, 32608 G2 wedge, incisional), unilateral 32609 Thoracoscopy; with biopsy(ies) of pleura G2 Removal of single or dual chamber implantable defibrillator electrode(s); by 33244 G2 transvenous extraction 33272 Removal of subcutaneous implantable defibrillator electrode G2 Embolectomy or thrombectomy, with or without catheter; axillary, brachial, 34101 G2 innominate, subclavian artery, by arm incision Embolectomy or thrombectomy, with or without catheter; radial or ulnar 34111 G2 artery, by arm incision Embolectomy or thrombectomy, with or without catheter; femoropopliteal, 34201 G2 aortoiliac artery, by leg incision Embolectomy or thrombectomy, with or without catheter; popliteal-tibio- 34203 G2 peroneal artery, by leg incision Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal vein, 34421 G2 by leg incision 34471 Thrombectomy, direct or with catheter; subclavian vein, by neck incision G2 34501 Valvuloplasty, femoral vein G2 34510 Venous valve transposition, any vein donor G2 34520 Cross-over vein graft to venous system G2 34530 Saphenopopliteal vein anastomosis G2 Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and 35011 graft insertion, with or without patch graft; for aneurysm and associated G2 occlusive disease, axillary-brachial artery, by arm incision Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and 35045 graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, G2 and associated occlusive disease, radial or ulnar artery 35180 Repair, congenital arteriovenous fistula; head and neck G2 CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator 35184 Repair, congenital arteriovenous fistula; extremities G2 35190 Repair, acquired or traumatic arteriovenous fistula; extremities G2 35201 Repair blood vessel, direct; neck G2 35206 Repair blood vessel, direct; upper extremity G2 35226 Repair blood vessel, direct; lower extremity G2 35231 Repair blood vessel with vein graft; neck G2 35236 Repair blood vessel with vein graft; upper extremity G2 35256 Repair blood vessel with vein graft; lower extremity G2 35261 Repair blood vessel with graft other than vein; neck G2 35266 Repair blood vessel with graft other than vein; upper extremity G2 35286 Repair blood vessel with graft other than vein; lower extremity G2 35321 Thromboendarterectomy, including patch graft, if performed; axillary-brachial G2 35860 Exploration for postoperative hemorrhage, thrombosis or infection; extremity G2 Revision, lower extremity arterial bypass, without thrombectomy, open; with 35879 G2 vein patch angioplasty Revision, lower extremity arterial bypass, without thrombectomy, open; with 35881 G2 segmental vein interposition Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; 35883 G2 with nonautogenous patch graft (eg, dacron, eptfe, bovine pericardium) Revision, femoral anastomosis of synthetic arterial bypass graft in groin, open; 35884 G2 with autogenous vein patch graft 35903 Excision of infected graft; extremity G2 36460 Transfusion, intrauterine, fetal G2 Distal revascularization and interval ligation (dril), upper extremity 36838 G2 hemodialysis access (steal syndrome) Revision of transvenous intrahepatic portosystemic shunt(s) (tips) (includes venous access, hepatic and portal vein catheterization, portography with 37183 J8 hemodynamic evaluation, intrahepatic tract recannulization/dilatation, stent placement and all associated imaging guidance and documentation) Insertion of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and 37191 J8 interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed Repositioning of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and 37192 J8 interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed Retrieval (removal) of intravascular vena cava filter, endovascular approach including vascular access, vessel selection, and radiological supervision and 37193 G2 interpretation, intraprocedural roadmapping, and imaging guidance (ultrasound and fluoroscopy), when performed 37195 Thrombolysis, cerebral, by intravenous infusion G2 Transcatheter therapy, arterial or venous infusion for thrombolysis other than 37213 coronary, any method, including radiological supervision and interpretation, G2 continued treatment on subsequent day during course of thrombolytic therapy, CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator including follow-up catheter contrast injection, position change, or exchange, when performed; Transcatheter therapy, arterial or venous infusion for thrombolysis other than coronary, any method, including radiological supervision and interpretation, continued treatment on subsequent day during course of thrombolytic therapy, 37214 G2 including follow-up catheter contrast injection, position change, or exchange, when performed; cessation of thrombolysis including removal of catheter and vessel closure by any method Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance 37244 J8 necessary to complete the intervention; for arterial or venous hemorrhage or lymphatic extravasation 37565 Ligation, internal jugular vein G2 37600 Ligation; external carotid artery G2 37605 Ligation; internal or common carotid artery G2 Ligation; internal or common carotid artery, with gradual occlusion, as with 37606 G2 selverstone or crutchfield clamp 37615 Ligation, major artery (eg, post-traumatic, rupture); neck G2 37619 Ligation of inferior vena cava G2 38120 Laparoscopy, surgical, splenectomy G2 Transplant preparation of hematopoietic progenitor cells; cryopreservation and 38207 G2 storage Transplant preparation of hematopoietic progenitor cells; thawing of 38208 G2 previously frozen harvest, without washing, per donor Transplant preparation of hematopoietic progenitor cells; thawing of 38209 G2 previously frozen harvest, with washing, per donor Transplant preparation of hematopoietic progenitor cells; specific cell 38210 G2 depletion within harvest, t-cell depletion 38211 Transplant preparation of hematopoietic progenitor cells; tumor cell depletion G2 Transplant preparation of hematopoietic progenitor cells; red blood cell 38212 G2 removal 38213 Transplant preparation of hematopoietic progenitor cells; platelet depletion G2 Transplant preparation of hematopoietic progenitor cells; plasma (volume) 38214 G2 depletion Transplant preparation of hematopoietic progenitor cells; cell concentration in 38215 G2 plasma, mononuclear, or buffy coat layer 38240 Hematopoietic progenitor cell (hpc); allogeneic transplantation per donor G2 38531 Biopsy or excision of lymph node(s); open, inguinofemoral node(s) G2 38720 Cervical lymphadenectomy (complete) G2 Mediastinoscopy; includes biopsy(ies) of mediastinal mass (eg, lymphoma), 39401 G2 when performed 39402 Mediastinoscopy; with lymph node biopsy(ies) (eg, lung cancer staging) G2 Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; without 42842 G2 closure CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure 42844 G2 with local flap (eg, tongue, buccal) 43020 Esophagotomy, cervical approach, with removal of foreign body G2 Laparoscopy, surgical, esophagogastric fundoplasty (eg, nissen, toupet 43280 G2 procedures) Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, 43281 G2 when performed; without implantation of mesh Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, 43282 G2 when performed; with implantation of mesh 43420 Closure of esophagostomy or fistula; cervical approach G2 Gastrotomy; with esophageal dilation and insertion of permanent intraluminal 43510 G2 tube (eg, celestin or mousseaux-barbin) Laparoscopy, surgical; implantation or replacement of gastric neurostimulator 43647 J8 electrodes, antrum Laparoscopy, surgical; revision or removal of gastric neurostimulator 43648 G2 electrodes, antrum 43651 Laparoscopy, surgical; transection of vagus nerves, truncal G2 Laparoscopy, surgical; transection of vagus nerves, selective or highly 43652 G2 selective Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable 43770 J8 gastric restrictive device (eg, gastric band and subcutaneous port components) Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable 43772 G2 gastric restrictive device component only Laparoscopy, surgical, gastric restrictive procedure; removal and replacement 43773 G2 of adjustable gastric restrictive device component only Laparoscopy, surgical, gastric restrictive procedure; removal of adjustable 43774 G2 gastric restrictive device and subcutaneous port components Gastrostomy, open; without construction of gastric tube (eg, stamm procedure) 43830 G2 (separate procedure) 43831 Gastrostomy, open; neonatal, for feeding G2 Laparoscopy, surgical, enterolysis (freeing of intestinal adhesion) (separate 44180 G2 procedure) 44186 Laparoscopy, surgical; jejunostomy (eg, for decompression or feeding) G2 44950 Appendectomy; G2 Appendectomy; when done for indicated purpose at time of other major 44955 procedure (not as separate procedure) (list separately in addition to code for N1 primary procedure) 44970 Laparoscopy, surgical, appendectomy G2 47370 Laparoscopy, surgical, ablation of 1 or more liver tumor(s); radiofrequency G2 47371 Laparoscopy, surgical, ablation of 1 or more liver tumor(s); cryosurgical G2 Cholecystostomy, percutaneous, complete procedure, including imaging 47490 guidance, catheter placement, cholecystogram when performed, and G2 radiological supervision and interpretation Sclerotherapy of a fluid collection (eg, lymphocele, cyst, or seroma), 49185 G2 percutaneous, including contrast injection(s), sclerosant injection(s), diagnostic CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator study, imaging guidance (eg, ultrasound, fluoroscopy) and radiological supervision and interpretation when performed 49323 Laparoscopy, surgical; with drainage of lymphocele to peritoneal cavity G2 Image-guided fluid collection drainage by catheter (eg, abscess, hematoma, 49405 seroma, lymphocele, cyst); visceral (eg, kidney, liver, spleen, G2 lung/mediastinum), percutaneous Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation 49491 at birth), performed from birth up to 50 weeks postconception age, with or G2 without hydrocelectomy; reducible Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation 49492 at birth), performed from birth up to 50 weeks postconception age, with or G2 without hydrocelectomy; incarcerated or strangulated 50020 Drainage of perirenal or renal abscess, open G2 50541 Laparoscopy, surgical; ablation of renal cysts G2 Laparoscopy, surgical; ablation of renal mass lesion(s), including 50542 G2 intraoperative ultrasound guidance and monitoring, when performed 50543 Laparoscopy, surgical; partial nephrectomy G2 50544 Laparoscopy, surgical; pyeloplasty G2 50945 Laparoscopy, surgical; ureterolithotomy G2 51060 Transvesical ureterolithotomy G2 Abdomino-vaginal vesical neck suspension, with or without endoscopic 51845 G2 control (eg, stamey, raz, modified pereyra) 51860 Cystorrhaphy, suture of bladder wound, injury or rupture; simple G2 51990 Laparoscopy, surgical; urethral suspension for stress incontinence G2 Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, 53500 G2 postsurgical obstruction, scarring) 1-stage proximal penile or penoscrotal hypospadias repair requiring extensive 54332 dissection to correct chordee and urethroplasty by use of skin graft tube and/or G2 island flap 1-stage perineal hypospadias repair requiring extensive dissection to correct 54336 G2 chordee and urethroplasty by use of skin graft tube and/or island flap Removal and replacement of all components of a multi-component inflatable 54411 penile prosthesis through an infected field at the same operative session, J8 including irrigation and debridement of infected tissue Removal and replacement of non-inflatable (semi-rigid) or inflatable (self- 54417 contained) penile prosthesis through an infected field at the same operative J8 session, including irrigation and debridement of infected tissue 54535 Orchiectomy, radical, for tumor; with abdominal exploration G2 Orchiopexy, abdominal approach, for intra-abdominal testis (eg, fowler- 54650 G2 stephens) Laparoscopy, surgical prostatectomy, retropubic radical, including nerve 55866 G2 sparing, includes robotic assistance, when performed 55970 Intersex surgery; male to female G2 55980 Intersex surgery; female to male G2 57106 Vaginectomy, partial removal of vaginal wall; G2 CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Vaginectomy, partial removal of vaginal wall; with removal of paravaginal 57107 G2 tissue (radical vaginectomy) Vaginectomy, partial removal of vaginal wall; with removal of paravaginal 57109 tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and G2 para-aortic lymph node sampling (biopsy) 57282 Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) G2 Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator 57283 G2 myorrhaphy) Paravaginal defect repair (including repair of cystocele, if performed); open 57284 G2 abdominal approach Paravaginal defect repair (including repair of cystocele, if performed); vaginal 57285 G2 approach 57292 Construction of artificial vagina; with graft G2 57330 Closure of vesicovaginal fistula; transvesical and vaginal approach G2 57335 Vaginoplasty for intersex state G2 Paravaginal defect repair (including repair of cystocele, if performed), 57423 G2 laparoscopic approach 57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex) G2 Excision of cervical stump, vaginal approach; with anterior and/or posterior 57555 G2 repair Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or 58263 G2 ovary(s), with repair of enterocele 58270 Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele G2 58290 Vaginal hysterectomy, for uterus greater than 250 g; G2 Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) 58291 G2 and/or ovary(s) Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) 58292 G2 and/or ovary(s), with repair of enterocele 58294 Vaginal hysterectomy, for uterus greater than 250 g; with repair of enterocele G2 58770 Salpingostomy (salpingoneostomy) G2 58920 Wedge resection or bisection of ovary, unilateral or bilateral G2 58925 Ovarian cystectomy, unilateral or bilateral G2 59030 Fetal scalp blood sampling G2 59409 Vaginal delivery only (with or without episiotomy and/or forceps); G2 Vaginal delivery only, after previous cesarean delivery (with or without 59612 G2 episiotomy and/or forceps); 60252 Thyroidectomy, total or subtotal for malignancy; with limited neck dissection G2 Thyroidectomy, removal of all remaining thyroid tissue following previous 60260 G2 removal of a portion of thyroid 60271 Thyroidectomy, including substernal thyroid; cervical approach G2 60502 Parathyroidectomy or exploration of parathyroid(s); re-exploration G2 Parathyroid autotransplantation (list separately in addition to code for primary 60512 N1 procedure) 60520 Thymectomy, partial or total; transcervical approach (separate procedure) G2 CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant 61623 J8 neurological monitoring, and radiologic supervision and interpretation of all angiography required for balloon occlusion and to exclude vascular injury post occlusion Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any 61626 J8 method; non-central nervous system, head or neck (extracranial, brachiocephalic branch) Creation of lesion by stereotactic method, including burr hole(s) and localizing 61720 and recording techniques, single or multiple stages; globus pallidus or G2 thalamus 62000 Elevation of depressed skull fracture; simple, extradural G2 Implantation, revision or repositioning of tunneled intrathecal or epidural 62351 catheter, for long-term medication administration via an external pump or G2 implantable reservoir/infusion pump; with laminectomy Laminectomy with exploration and/or decompression of spinal cord and/or 63011 cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal G2 stenosis), 1 or 2 vertebral segments; sacral Laminectomy with removal of abnormal facets and/or pars inter-articularis 63012 with decompression of cauda equina and nerve roots for spondylolisthesis, G2 lumbar (gill type procedure) Laminectomy with exploration and/or decompression of spinal cord and/or 63015 cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal G2 stenosis), more than 2 vertebral segments; cervical Laminectomy with exploration and/or decompression of spinal cord and/or 63016 cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal G2 stenosis), more than 2 vertebral segments; thoracic Laminectomy with exploration and/or decompression of spinal cord and/or 63017 cauda equina, without facetectomy, foraminotomy or discectomy (eg, spinal G2 stenosis), more than 2 vertebral segments; lumbar Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated 63035 N1 intervertebral disc; each additional interspace, cervical or lumbar (list separately in addition to code for primary procedure) Laminotomy (hemilaminectomy), with decompression of nerve root(s), 63040 including partial facetectomy, foraminotomy and/or excision of herniated G2 intervertebral disc, reexploration, single interspace; cervical Laminotomy (hemilaminectomy), with decompression of nerve root(s), including partial facetectomy, foraminotomy and/or excision of herniated 63043 N1 intervertebral disc, reexploration, single interspace; each additional cervical interspace (list separately in addition to code for primary procedure) Laminectomy, facetectomy and foraminotomy (unilateral or bilateral with 63048 decompression of spinal cord, cauda equina and/or nerve root[s], [eg, spinal or N1 lateral recess stenosis]), single vertebral segment; each additional segment, CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator cervical, thoracic, or lumbar (list separately in addition to code for primary procedure) Transpedicular approach with decompression of spinal cord, equina and/or nerve root(s) (eg, herniated intervertebral disc), single segment; each 63057 N1 additional segment, thoracic or lumbar (list separately in addition to code for primary procedure) Costovertebral approach with decompression of spinal cord or nerve root(s) 63064 G2 (eg, herniated intervertebral disc), thoracic; single segment Costovertebral approach with decompression of spinal cord or nerve root(s) 63066 (eg, herniated intervertebral disc), thoracic; each additional segment (list N1 separately in addition to code for primary procedure) Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), 63075 J8 including osteophytectomy; cervical, single interspace Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), 63076 including osteophytectomy; cervical, each additional interspace (list separately N1 in addition to code for primary procedure) Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; 63741 J8 percutaneous, not requiring laminectomy 64804 Sympathectomy, cervicothoracic G2 Nerve repair; with autogenous vein graft (includes harvest of vein graft), each 64911 G2 nerve Decompression facial nerve, intratemporal; including medial to geniculate 69725 G2 ganglion 69955 Total facial nerve decompression and/or repair (may include graft) G2 69960 Decompression internal auditory canal G2 69970 Removal of tumor, temporal bone G2 Percutaneous transluminal coronary atherectomy, with drug eluting C9602 intracoronary stent, with coronary angioplasty when performed; single major J8 coronary artery or branch Percutaneous transluminal coronary atherectomy, with drug-eluting intracoronary stent, with coronary angioplasty when performed; each C9603 N1 additional branch of a major coronary artery (list separately in addition to code for primary procedure) Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of C9604 J8 drug-eluting intracoronary stent, atherectomy and angioplasty, including distal protection when performed; single vessel Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of C9605 drug-eluting intracoronary stent, atherectomy and angioplasty, including distal N1 protection when performed; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure) Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any C9607 J8 combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any C9608 combination of drug-eluting intracoronary stent, atherectomy and angioplasty; N1 each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure) Bronchoscopy, rigid or flexible, transbronchial ablation of lesion(s) by microwave energy, including fluoroscopic guidance, when performed, with computed tomography acquisition(s) and 3-d rendering, computer-assisted, C9751 image-guided navigation, and endobronchial ultrasound (ebus) guided G2 transtracheal and/or transbronchial sampling (eg, aspiration[s]/biopsy[ies]) and all mediastinal and/or hilar lymph node stations or structures and therapeutic intervention(s) Blinded procedure for nyha class iii/iv heart failure; transcatheter implantation of interatrial shunt or placebo control, including right heart catheterization, C9758 trans-esophageal echocardiography (tee)/intracardiac echocardiography (ice), G2 and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (ide) study Excision of rectal tumor, transanal endoscopic microsurgical approach (ie, 0184T G2 tems), including muscularis propria (ie, full thickness) Placement of a posterior intrafacet implant(s), unilateral or bilateral, including 0221T imaging and placement of bone graft(s) or synthetic device(s), single level; G2 lumbar Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, 0266T G2 intra-operative interrogation, programming, and repositioning, when performed) Implantation or replacement of carotid sinus baroreflex activation device; lead 0267T only, unilateral (includes intra-operative interrogation, programming, and G2 repositioning, when performed) Implantation or replacement of carotid sinus baroreflex activation device; 0268T pulse generator only (includes intra-operative interrogation, programming, and J8 repositioning, when performed) Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to 0312T G2 esophagogastric junction (egj), with implantation of pulse generator, includes programming Transcervical uterine fibroid(s) ablation with ultrasound guidance, 0404T G2 radiofrequency Insertion or replacement of a permanently implantable aortic counterpulsation 0453T ventricular assist system, endovascular approach, and programming of sensing G2 and therapeutic parameters; mechano-electrical skin interface Insertion or replacement of a permanently implantable aortic counterpulsation 0454T ventricular assist system, endovascular approach, and programming of sensing G2 and therapeutic parameters; subcutaneous electrode Removal of permanently implantable aortic counterpulsation ventricular assist 0457T G2 system; mechano-electrical skin interface CY 2021 Proposed CY CPT/ 2021 ASC CY 2021 Long Descriptor HCPCS Payment Code Indicator Removal of permanently implantable aortic counterpulsation ventricular assist 0458T G2 system; subcutaneous electrode Repositioning of previously implanted aortic counterpulsation ventricular 0460T G2 assist device; subcutaneous electrode Cystourethroscopy, with mechanical dilation and urethral therapeutic drug 0499T delivery for urethral stricture or stenosis, including fluoroscopy, when G2 performed Endovenous femoral-popliteal arterial revascularization, with transcatheter placement of intravascular stent graft(s) and closure by any method, including percutaneous or open vascular access, ultrasound guidance for vascular access 0505T when performed, all catheterization(s) and intraprocedural roadmapping and J8 imaging guidance necessary to complete the intervention, all associated radiological supervision and interpretation, when performed, with crossing of the occlusive lesion in an extraluminal fashion Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and 0515T G2 interpretation, when performed; complete system (includes electrode and generator [transmitter and battery]) Insertion of wireless cardiac stimulator for left ventricular pacing, including 0516T device interrogation and programming, and imaging supervision and J8 interpretation, when performed; electrode only Insertion of wireless cardiac stimulator for left ventricular pacing, including device interrogation and programming, and imaging supervision and 0517T J8 interpretation, when performed; pulse generator component(s) (battery and/or transmitter) only Removal of only pulse generator component(s) (battery and/or transmitter) of 0518T J8 wireless cardiac stimulator for left ventricular pacing Removal and replacement of wireless cardiac stimulator for left ventricular 0519T G2 pacing; pulse generator component(s) (battery and/or transmitter) Removal and replacement of wireless cardiac stimulator for left ventricular 0520T pacing; pulse generator component(s) (battery and/or transmitter), including J8 placement of a new electrode