Page 1 of 30 Medicare IP Only List 2019 Cardiovascular System CPT/ HCPCS Short Description Long Description Removed from IP only list Added to IP only list 33015 Incision of heart sac Tube pericardiostomy 33020 Incision of heart sac Pericardiotomy for removal of clot or foreign body (primary procedure) 33025 Incision of heart sac Creation of pericardial window or partial resection for drainage

33030 Partial removal of heart sac Pericardiectomy, subtotal or complete; without cardiopulmonary bypass 33031 Partial removal of heart sac Pericardiectomy, subtotal or complete; with cardiopulmonary bypass 33050 Resect of heart sac lesion Excision of pericardial cyst or tumor 33120 Removal of heart lesion Excision of intracardiac tumor, resection with cardiopulmonary bypass 33130 Removal of heart lesion Resection of external cardiac tumor Transmyocardial laser revascularization, by thoracotomy; (separate 33140 Heart revascularize (tmr) procedure) Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to 33141 Heart tmr w/other procedure code for primary procedure) Insertion of epicardial electrode(s); open incision (eg, thoracotomy, 33202 Insert epicard eltrd open median sternotomy, subxiphoid approach) Insertion of epicardial electrode(s); endoscopic approach (eg, 33203 Insert epicard eltrd endo thoracoscopy, pericardioscopy) Removal of permanent epicardial pacemaker and electrodes by 33236 Remove electrode/thoracotomy thoracotomy; single lead system, atrial or ventricular Removal of permanent epicardial pacemaker and electrodes by 33237 Remove electrode/thoracotomy thoracotomy; dual lead system

33238 Remove electrode/thoracotomy Removal of permanent transvenous electrode(s) by thoracotomy Removal of single or dual chamber pacing cardioverter-defibrillator 33243 Remove eltrd/thoracotomy electrode(s); by thoracotomy Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) 33250 Ablate heart dysrhythm focus and/or focus (foci); without cardiopulmonary bypass Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) 33251 Ablate heart dysrhythm focus and/or focus (foci); with cardiopulmonary bypass Operative tissue ablation and reconstruction of atria, limited (eg, 33254 Ablate atria lmtd modified maze procedure) Operative tissue ablation and reconstruction of atria, extensive (eg, 33255 Ablate atria w/o bypass ext maze procedure); without cardiopulmonary bypass Page 2 of 30 CPT/ HCPCS Short Description Long Description Operative tissue ablation and reconstruction of atria, extensive (eg, 33256 Ablate atria w/bypass exten maze procedure); with cardiopulmonary bypass Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze 33257 Ablate atria lmtd add-on procedure) (list separately in addition to code for primary procedure) Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for 33258 Ablate atria x10sv add-on primary procedure) Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary 33259 Ablate atria w/bypass add-on procedure) Operative ablation of ventricular arrhythmogenic focus with 33261 Ablate heart dysrhythm focus cardiopulmonary bypass Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary 33265 Ablate atria lmtd endo bypass Endoscopy, surgical; operative tissue ablation and reconstruction of 33266 Ablate atria x 10sv endo atria, extensive (eg, maze procedure), without cardiopulmonary bypass 33300 Repair of heart wound Repair of cardiac wound; without bypass 33305 Repair of heart wound Repair of cardiac wound; with cardiopulmonary bypass Cardiotomy, exploratory (includes removal of foreign body, atrial or 33310 Exploratory heart surgery ventricular thrombus); without bypass Cardiotomy, exploratory (includes removal of foreign body, atrial or 33315 Exploratory heart surgery ventricular thrombus); with cardiopulmonary bypass Suture repair of aorta or great vessels; without shunt or cardiopulmonary 33320 Repair major blood vessel(s) bypass 33321 Repair major vessel Suture repair of aorta or great vessels; with shunt bypass 33322 Repair major blood vessel(s) Suture repair of aorta or great vessels; with cardiopulmonary bypass Insertion of graft, aorta or great vessels; without shunt, or 33330 Insert major vessel graft cardiopulmonary bypass 33335 Insert major vessel graft Insertion of graft, aorta or great vessels; with cardiopulmonary bypass Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and 33340 Perq clsr tcat l atr apndge interpretation Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic 33361 Replace aortic valve perq valve; percutaneous femoral artery approach Page 3 of 30 CPT/ HCPCS Short Description Long Description Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic 33362 Replace aortic valve open valve; open femoral artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic 33363 Replace aortic valve open valve; open axillary artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic 33364 Replace aortic valve open valve; open iliac artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic 33365 Replace aortic valve open valve; transaortic approach (eg, median sternotomy, mediastinotomy) Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; 33366 Trcath replace aortic valve transapical exposure (eg, left thoracotomy) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in 33367 Replace aortic valve w/byp addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in 33368 Replace aortic valve w/byp addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in 33369 Replace aortic valve w/byp addition to code for primary procedure) Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural 33390 Valvuloplasty aortic valve resuspension) Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or 33391 Valvuloplasty aortic valve annuloplasty) 33404 Prepare heart-aorta conduit Construction of apical-aortic conduit Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic 33405 Replacement of aortic valve valve other than homograft or stentless valve Replacement, aortic valve, with cardiopulmonary bypass; with allograft 33406 Replacement of aortic valve valve (freehand) Replacement, aortic valve, with cardiopulmonary bypass; with stentless 33410 Replacement of aortic valve tissue valve Replacement, aortic valve; with aortic annulus enlargement, 33411 Replacement of aortic valve noncoronary cusp Replacement, aortic valve; with transventricular aortic annulus 33412 Replacement of aortic valve enlargement (Konno procedure) Replacement, aortic valve; by translocation of autologous pulmonary 33413 Replacement of aortic valve valve with allograft replacement of pulmonary valve (Ross procedure) Page 4 of 30 CPT/ HCPCS Short Description Long Description Repair of left ventricular outflow tract obstruction by patch enlargement 33414 Repair of aortic valve of the outflow tract Resection or incision of subvalvular tissue for discrete subvalvular aortic 33415 Revision subvalvular tissue stenosis Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic 33416 Revise ventricle muscle stenosis (eg, asymmetric septal hypertrophy) 33417 Repair of aortic valve Aortoplasty (gusset) for supravalvular stenosis Transcatheter mitral valve repair, percutaneous approach, including 33418 Repair tcat mitral valve transseptal puncture when performed; initial prosthesis 33420 Revision of mitral valve Valvotomy, mitral valve; closed heart 33422 Revision of mitral valve Valvotomy, mitral valve; open heart, with cardiopulmonary bypass 33425 Repair of mitral valve Valvuloplasty, mitral valve, with cardiopulmonary bypass; Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic 33426 Repair of mitral valve ring Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical 33427 Repair of mitral valve reconstruction, with or without ring 33430 Replacement of mitral valve Replacement, mitral valve, with cardiopulmonary bypass Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary 33440 Replacement, aortic valve valve 33460 Revision of tricuspid valve Valvectomy, tricuspid valve, with cardiopulmonary bypass 33463 Valvuloplasty tricuspid Valvuloplasty, tricuspid valve; without ring insertion 33464 Valvuloplasty tricuspid Valvuloplasty, tricuspid valve; with ring insertion 33465 Replace tricuspid valve Replacement, tricuspid valve, with cardiopulmonary bypass 33468 Revision of tricuspid valve Tricuspid valve repositioning and plication for Ebstein anomaly 33470 Revision of pulmonary valve Valvotomy, pulmonary valve, closed heart; transventricular 33471 Valvotomy pulmonary valve Valvotomy, pulmonary valve, closed heart; via pulmonary artery 33474 Revision of pulmomary valve Valvotomy, pulmonary valve, open heart; with cardiopulmonary bypass 33475 Replacement pulmonary valve Replacement, pulmonary valve Right ventricular resection for infundibular stenosis, with or without 33476 Revision of heart chamber commissurotomy Transcatheter pulmonary valve implantation, percutaneous approach, 33477 Implant tcat pulm vlv perq including pre-stenting of the valve delivery site, when performed Outflow tract augmentation (gusset), with or without commissurotomy or 33478 Revision of heart chamber infundibular resection Repair of non-structural prosthetic valve dysfunction with 33496 Repair prosth valve clot cardiopulmonary bypass (separate procedure) Repair of coronary arteriovenous or arteriocardiac chamber fistula; with 33500 Repair heart vessel fistula cardiopulmonary bypass Page 5 of 30 CPT/ HCPCS Short Description Long Description Repair of coronary arteriovenous or arteriocardiac chamber fistula; 33501 Repair heart vessel fistula without cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; by 33502 Coronary artery correction ligation Repair of anomalous coronary artery from pulmonary artery origin; by 33503 Coronary artery graft graft, without cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; by 33504 Coronary artery graft graft, with cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; with 33505 Repair artery w/tunnel construction of intrapulmonary artery tunnel (Takeuchi procedure) Repair of anomalous coronary artery from pulmonary artery origin; by 33506 Repair artery translocation translocation from pulmonary artery to aorta Repair of anomalous (eg, intramural) aortic origin of coronary artery by 33507 Repair art intramural unroofing or translocation 33510 Cabg vein single Coronary artery bypass, vein only; single coronary venous graft 33511 Cabg vein two Coronary artery bypass, vein only; two coronary venous grafts 33512 Cabg vein three Coronary artery bypass, vein only; three coronary venous grafts 33513 Cabg vein four Coronary artery bypass, vein only; four coronary venous grafts 33514 Cabg vein five Coronary artery bypass, vein only; five coronary venous grafts 33516 Cabg vein six or more Coronary artery bypass, vein only; six or more coronary venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); 33517 Cabg artery-vein single single vein graft (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); two 33518 Cabg artery-vein two venous grafts (List separately in addition to code for arterial graft)

Coronary artery bypass, using venous graft(s) and arterial graft(s); three 33519 Cabg artery-vein three venous grafts (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); four 33521 Cabg artery-vein four venous grafts (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); five 33522 Cabg artery-vein five venous grafts (List separately in addition to code for arterial graft)

Coronary artery bypass, using venous graft(s) and arterial graft(s); six or 33523 Cabg art-vein six or more more venous grafts (List separately in addition to code for arterial graft) Reoperation, coronary artery bypass procedure or valve procedure, more than one month after original operation (List separately in addition 33530 Coronary artery bypass/rcop to code for primary procedure) 33533 Cabg arterial single Coronary artery bypass, using arterial graft(s); single arterial graft Coronary artery bypass, using arterial graft(s); two coronary arterial 33534 Cabg arterial two grafts Page 6 of 30 CPT/ HCPCS Short Description Long Description Coronary artery bypass, using arterial graft(s); three coronary arterial 33535 Cabg arterial three grafts Coronary artery bypass, using arterial graft(s); four or more coronary 33536 Cabg arterial four or more arterial grafts 33542 Removal of heart lesion Myocardial resection (eg, ventricular aneurysmectomy) Repair of postinfarction ventricular septal defect, with or without 33545 Repair of heart damage myocardial resection Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, DOR 33548 Restore/remodel ventricle procedures) Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List separately 33572 Open coronary endarterectomy in addition to primary procedure) 33600 Closure of valve Closure of atrioventricular valve (mitral or tricuspid) by suture or patch 33602 Closure of valve Closure of semilunar valve (aortic or pulmonary) by suture or patch Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel 33606 Anastomosis/artery-aorta procedure) Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from 33608 Repair anomaly w/conduit right or left ventricle to pulmonary artery

Repair of complex cardiac anomalies (eg, single ventricle with subaortic 33610 Repair by enlargement obstruction) by surgical enlargement of ventricular septal defect 33611 Repair double ventricle Repair of double outlet right ventricle with intraventricular tunnel repair; Repair of double outlet right ventricle with intraventricular tunnel repair; 33612 Repair double ventricle with repair of right ventricular outflow tract obstruction Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary 33615 Repair modified fontan artery (simple Fontan procedure) Repair of complex cardiac anomalies (eg, single ventricle) by modified 33617 Repair single ventricle Fontan procedure Repair of single ventricle with aortic outflow obstruction and aortic arch 33619 Repair single ventricle hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure) Application of right and left pulmonary artery bands (eg, hybrid approach 33620 Apply r&l pulm art bands stage 1) Transthoracic insertion of catheter for stent placement with catheter 33621 Transthor cath for stent removal and closure (eg, hybrid approach stage 1) Page 7 of 30 CPT/ HCPCS Short Description Long Description Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2, norwood, bidirectional glenn, pulmonary artery 33622 Redo compl cardiac anomaly debanding) Repair atrial septal defect, secundum, with cardiopulmonary bypass, 33641 Repair heart septum defect with or without patch Direct or patch closure, sinus venosus, with or without anomalous 33645 Revision of heart veins pulmonary venous drainage Repair of atrial septal defect and ventricular septal defect, with direct or 33647 Repair heart septum defects patch closure Repair of incomplete or partial atrioventricular canal (ostium primum 33660 Repair of heart defects atrial septal defect), with or without atrioventricular valve repair Repair of intermediate or transitional atrioventricular canal, with or 33665 Repair of heart defects without atrioventricular valve repair

33670 Repair of heart chambers Repair of complete atrioventricular canal, with or without prosthetic valve 33675 Close mult vsd Closure of multiple ventricular septal defects; Closure of multiple ventricular septal defects; with pulmonary valvotomy 33676 Close mult vsd w/resection or infundibular resection (acyanotic) Closure of multiple ventricular septal defects; with removal of pulmonary 33677 Cl mult vsd w/rem pul band artery band, with or without gusset 33681 Repair heart septum defect Closure of single ventricular septal defect, with or without patch; Closure of single ventricular septal defect, with or without patch; with 33684 Repair heart septum defect pulmonary valvotomy or infundibular resection (acyanotic) Closure of single ventricular septal defect, with or without patch; with 33688 Repair heart septum defect removal of pulmonary artery band, with or without gusset 33690 Reinforce pulmonary artery Banding of pulmonary artery 33692 Repair of heart defects Complete repair tetralogy of Fallot without pulmonary atresia; Complete repair tetralogy of Fallot without pulmonary atresia; with 33694 Repair of heart defects transannular patch Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and 33697 Repair of heart defects closure of ventricular septal defect 33702 Repair of heart defects Repair sinus of Valsalva fistula, with cardiopulmonary bypass; Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair 33710 Repair of heart defects of ventricular septal defect 33720 Repair of heart defect Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass 33722 Repair of heart defect Closure of aortico-left ventricular tunnel Page 8 of 30 CPT/ HCPCS Short Description Long Description Repair of isolated partial anomalous pulmonary venous return (eg, 33724 Repair venous anomaly Scimitar Syndrome) 33726 Repair pul venous stenosis Repair of pulmonary venous stenosis Complete repair of anomalous pulmonary venous return (supracardiac, 33730 Repair heart-vein defect(s) intracardiac, or infracardiac types) Repair of cor triatriatum or supravalvular mitral ring by resection of left 33732 Repair heart-vein defect atrial membrane Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type 33735 Revision of heart chamber operation) Atrial septectomy or septostomy; open heart with cardiopulmonary 33736 Revision of heart chamber bypass 33737 Revision of heart chamber Atrial septectomy or septostomy; open heart, with inflow occlusion

33750 Major vessel shunt Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) 33755 Major vessel shunt Shunt; ascending aorta to pulmonary artery (Waterston type operation) Shunt; descending aorta to pulmonary artery (Potts-Smith type 33762 Major vessel shunt operation) 33764 Major vessel shunt & graft Shunt; central, with prosthetic graft Shunt; superior vena cava to pulmonary artery for flow to one lung 33766 Major vessel shunt (classical Glenn procedure) Shunt; superior vena cava to pulmonary artery for flow to both lungs 33767 Major vessel shunt (bidirectional Glenn procedure) Anastomosis, cavopulmonary, second superior vena cava (List 33768 Cavopulmonary shunting separately in addition to primary procedure) Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular 33770 Repair great vessels defect septal defect Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular 33771 Repair great vessels defect septal defect Repair of transposition of the great arteries, atrial baffle procedure (eg, 33774 Repair great vessels defect Mustard or Senning type) with cardiopulmonary bypass; Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of 33775 Repair great vessels defect pulmonary band Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with closure of 33776 Repair great vessels defect ventricular septal defect Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with repair of 33777 Repair great vessels defect subpulmonic obstruction Page 9 of 30 CPT/ HCPCS Short Description Long Description Repair of transposition of the great arteries, aortic pulmonary artery 33778 Repair great vessels defect reconstruction (eg, Jatene type); Repair of transposition of the great arteries, aortic pulmonary artery 33779 Repair great vessels defect reconstruction (eg, Jatene type); with removal of pulmonary band

Repair of transposition of the great arteries, aortic pulmonary artery 33780 Repair great vessels defect reconstruction (eg, Jatene type); with closure of ventricular septal defect Repair of transposition of the great arteries, aortic pulmonary artery 33781 Repair great vessels defect reconstruction (eg, Jatene type); with repair of subpulmonic obstruction Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium 33782 Nikaidoh proc reimplantation Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both 33783 Nikaidoh proc w/ostia implt coronary ostia 33786 Repair arterial trunk Total repair, truncus arteriosus (Rastelli type operation) 33788 Revision of pulmonary artery Reimplantation of an anomalous pulmonary artery Aortic suspension (aortopexy) for tracheal decompression (eg, for 33800 Aortic suspension tracheomalacia) (separate procedure) 33802 Repair vessel defect Division of aberrant vessel (vascular ring); 33803 Repair vessel defect Division of aberrant vessel (vascular ring); with reanastomosis Obliteration of aortopulmonary septal defect; without cardiopulmonary 33813 Repair septal defect bypass Obliteration of aortopulmonary septal defect; with cardiopulmonary 33814 Repair septal defect bypass 33820 Revise major vessel Repair of patent ductus arteriosus; by ligation 33822 Revise major vessel Repair of patent ductus arteriosus; by division, younger than 18 years 33824 Revise major vessel Repair of patent ductus arteriosus; by division, 18 years and older Excision of coarctation of aorta, with or without associated patent ductus 33840 Remove aorta constriction arteriosus; with direct anastomosis Excision of coarctation of aorta, with or without associated patent ductus 33845 Remove aorta constriction arteriosus; with graft Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material 33851 Remove aorta constriction as gusset for enlargement Repair of hypoplastic or interrupted aortic arch using autogenous or 33852 Repair septal defect prosthetic material; without cardiopulmonary bypass Repair of hypoplastic or interrupted aortic arch using autogenous or 33853 Repair septal defect prosthetic material; with cardiopulmonary bypass Ascending aorta graft, with cardiopulmonary bypass, with or without 33860 Ascending aortic graft valve suspension; Page 10 of 30 CPT/ HCPCS Short Description Long Description Ascending aorta graft, with cardiopulmonary bypass, with or without valve suspension; with aortic root replacement using composite 33863 Ascending aortic graft prosthesis and coronary reconstruction Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root 33864 Ascending aortic graft remodeling (eg, david procedure, yacoub procedure) 33870 Transverse aortic arch graft Transverse arch graft, with cardiopulmonary bypass 33875 Thoracic aortic graft Descending thoracic aorta graft, with or without bypass Repair of thoracoabdominal aortic aneurysm with graft, with or without 33877 Thoracoabdominal graft cardiopulmonary bypass Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, 33880 Endovasc taa repr incl subcl initial endoprosthesis plus descending thora Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery 33881 Endovasc taa repr w/o subcl origin, initial endoprosthesis plus descending t Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial 33883 Insert endovasc prosth taa extension Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each 33884 Endovasc prosth taa add-on additional proximal extension (List separatel Placement of distal extension prosthesis(s) delayed after endovascular 33886 Endovasc prosth delayed repair of descending thoracic aorta Open subclavian to carotid artery transposition performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision, 33889 Artery transpose/endovas taa unilateral Bypass graft, with other than vein, transcervical retropharyngeal carotid- carotid, performed in conjunction with endovascular repair of descending 33891 Car-car bp grft/endovas taa thoracic aorta, by neck incision 33910 Remove lung artery emboli Pulmonary artery embolectomy; with cardiopulmonary bypass 33915 Remove lung artery emboli Pulmonary artery embolectomy; without cardiopulmonary bypass Pulmonary endarterectomy, with or without embolectomy, with 33916 Surgery of great vessel cardiopulmonary bypass

33917 Repair pulmonary artery Repair of pulmonary artery stenosis by reconstruction with patch or graft Page 11 of 30 CPT/ HCPCS Short Description Long Description Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to 33920 Repair pulmonary atresia pulmonary artery 33922 Transect pulmonary artery Transection of pulmonary artery with cardiopulmonary bypass Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List 33924 Remove pulmonary shunt separately in addition to code for primary procedure) Repair of pulmonary artery arborization anomalies by unifocalization; 33925 Rpr pul art unifocal w/o cpb without cardiopulmonary bypass Repair of pulmonary artery arborization anomalies by unifocalization; 33926 Repr pul art unifocal w/cpb with cardiopulmonary bypass Implantation of a total replacement heart system (artificial heart) with 33927 Implantation of artificial heart recipient cardiectomy

Removal and replacement of 33928 total replacement heart system Removal and replacement of total replacement heart system

Removal of a total replacement heart system (artificial heart) for heart 33929 Removal of artificial heart transplantation (List separately in addition to code for primary procedure) 33930 Removal of donor heart/lung Donor cardiectomy-pneumonectomy (including cold preservation) Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and 33933 Prepare donor heart/lung trachea for implantation 33935 Transplantation heart/lung Heart-lung transplant with recipient cardiectomy-pneumonectomy 33940 Removal of donor heart Donor cardiectomy (including cold preservation) Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, 33944 Prepare donor heart pulmonary artery, and left atrium for impla 33945 Transplantation of heart Heart transplant, with or without recipient cardiectomy Extracorporeal membrane oxygenation (ECMO)/extracorporeal life 33946 Ecmo/ecls initiation venous support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life 33947 Ecmo/ecls initiation artery support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, 33948 Ecmo/ecls daily mgmt-venous veno-venous Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, 33949 Ecmo/ecls daily mgmt artery veno-arteria Page 12 of 30 CPT/ HCPCS Short Description Long Description Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age 33951 Ecmo/ecls insj prph cannula (includes fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes 33952 Ecmo/ecls insj prph cannula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial 33953 Ecmo/ecls insj prph cannula and/or venous) cannula(e), open, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial 33954 Ecmo/ecls insj prph cannula and/or venous) cannula(e), open, 6 years and older Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by 33955 Ecmo/ecls insj ctr cannula sternotomy or thoracotomy, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by 33956 Ecmo/ecls insj ctr cannula sternotomy or thoracotomy, 6 years and older Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age 33957 Ecmo/ecls repos perph cnula (includes fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes 33958 Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes 33959 Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes 33962 Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes 33963 Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Page 13 of 30 CPT/ HCPCS Short Description Long Description Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic 33964 Ecmo/ecls repos perph cnula guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial 33965 Ecmo/ecls rmvl perph cannula and/or venous) cannula(e), percutaneous, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial 33966 Ecmo/ecls rmvl prph cannula and/or venous) cannula(e), percutaneous, 6 years and older 33967 Insert ia percut device Insertion of intra-aortic balloon assist device, percutaneous 33968 Remove aortic assist device Removal of intra-aortic balloon assist device, percutaneous Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial 33969 Ecmo/ecls rmvl perph cannula and/or venous) cannula(e), open, birth through 5 years of age Insertion of intra-aortic balloon assist device through the femoral artery, 33970 Aortic circulation assist open approach Removal of intra-aortic balloon assist device including repair of femoral 33971 Aortic circulation assist artery, with or without graft

33973 Insert balloon device Insertion of intra-aortic balloon assist device through the ascending aorta Removal of intra-aortic balloon assist device from the ascending aorta, 33974 Remove intra-aortic balloon including repair of the ascending aorta, with or without graft 33975 Implant ventricular device Insertion of ventricular assist device; extracorporeal, single ventricle 33976 Implant ventricular device Insertion of ventricular assist device; extracorporeal, biventricular 33977 Remove ventricular device Removal of ventricular assist device; extracorporeal, single ventricle 33978 Remove ventricular device Removal of ventricular assist device; extracorporeal, biventricular Insertion of ventricular assist device, implantable intracorporeal, single 33979 Insert intracorporeal device ventricle Removal of ventricular assist device, implantable intracorporeal, single 33980 Remove intracorporeal device ventricle Replacement of extracorporeal ventricular assist device, single or 33981 Replace vad pump ext biventricular, pump(s), single or each pump Replacement of ventricular assist device pump(s); implantable 33982 Replace vad intra w/o bp intracorporeal, single ventricle, without cardiopulmonary bypass Replacement of ventricular assist device pump(s); implantable 33983 Replace vad intra w/bp intracorporeal, single ventricle, with cardiopulmonary bypass Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; 33984 Ecmo/ecls rmvl prph cannula Page 14 of 30 CPT/ HCPCS Short Description Long Description Extracorporeal membrane oxygenation (ECMO)/extracorporeal life 33985 Ecmo/ecls rmvl ctr cannula support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life 33986 Ecmo/ecls rmvl ctr cannula support (ECLS) provided by physician; Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support 33987 Artery expos/graft artery Services Insertion of left heart vent Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support 33988 (ecmo) Services Removal of left heart vent Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support 33989 (ecmo) Services Insertion of ventricular assist device, percutaneous including radiological 33990 Insert vad artery access supervision and interpretation; arterial access only Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; both arterial and venous access, with 33991 Insert vad art&vein access transseptal puncture Removal of percutaneous ventricular assist device at separate and 33992 Remove vad different session distinct session from insertion Repositioning of percutaneous ventricular assist device with imaging 33993 Reposition vad diff session guidance at separate and distinct session from insertion Embolectomy or thrombectomy, with or without catheter; carotid, 34001 Removal of artery clot subclavian or innominate artery, by neck incision Embolectomy or thrombectomy, with or without catheter; innominate, 34051 Removal of artery clot subclavian artery, by thoracic incision Embolectomy or thrombectomy, with or without catheter; renal, celiac, 34151 Removal of artery clot mesentery, aortoiliac artery, by abdominal incision Thrombectomy, direct or with catheter; vena cava, iliac vein, by 34401 Removal of vein clot abdominal incision Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal 34451 Removal of vein clot vein, by abdominal and leg incision 34502 Reconstruct vena cava Reconstruction of vena cava, any method Embolectomy or thrombectomy, with or without catheter; axillary, 34701 Evasc rpr a-ao ndgft brachial, innominate, subclavian artery, by arm incision Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, 34702 Evasc rpr a-ao ndgft rpt dissection, penetrating ulcer, traumatic disruption) Page 15 of 30 CPT/ HCPCS Short Description Long Description Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for 34703 Evasc rpr a-unilac ndgft aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, 34704 Evasc rpr a-unilac ndgft rpt pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for 34705 Evac rpr a-biiliac ndgft aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, 34706 Evasc rpr a-biiliac rpt pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Page 16 of 30 CPT/ HCPCS Short Description Long Description Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous 34707 Evasc rpr ilio-iliac ndgft malformation) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, 34708 Evasc rpr ilio-iliac rpt traumatic disruption) Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code 34709 Plmt xtn prosth evasc rpr for primary procedure) Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; 34710 Dlyd plmt xtn prosth 1st vsl initial vessel treated Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; each additional vessel treated (List separately in addition to code for 34711 Dlyd plmt xtn prosth ea addl primary procedure) Page 17 of 30 CPT/ HCPCS Short Description Long Description Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and 34712 Tcat dlvr enhncd fixj dev interpretation Endovascular repair of infrarenal abdominal aortic aneurysm or 34800 Endovas aaa repr w/sm tube dissection; using aorto-aortic tube prosthesis Endovascular repair of infrarenal abdominal aortic aneurysm or 34802 Endovas aaa repr w/2-p part dissection; using modular bifurcated prosthesis (one docking limb) Endovascular repair of infrarenal abdominal aortic aneurysm or 34803 Endovas aaa repr w/3-p part dissection; using modular bifurcated prosthesis (two docking limbs) Endovascular repair of infrarenal abdominal aortic aneurysm or 34804 Endovas aaa repr w/1-p part dissection; using unibody bifurcated prosthesis Endovascular repair of infrarenal abdominal aortic aneurysm or 34805 Endovas aaa repr w/long tube dissection; using aorto-uniiliac or aorto-unifemoral prosthesis Transcatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological supervision and Aneurysm press sensor add- interpretation, instrument calibration, and collection of pressure data (list 34806 on separately in addition to code for primary procedure) Endovascular placement of iliac artery occlusion device (List separately 34808 Endovas iliac a device addon in addition to code for primary procedure) Open femoral artery exposure for delivery of endovascular prosthesis, 34812 Xpose for endoprosth femorl by groin incision, unilateral Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (List separately in addition to code for primary 34813 Femoral endovas graft add-on procedure) Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal 34820 Xpose for endoprosth iliac incision, unilateral Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, 34825 Endovasc extend prosth init or dissection; initial vessel Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection; each additional vessel (List separately in addition to code 34826 Endovasc exten prosth addl for primary procedure) Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; 34830 Open aortic tube prosth repr tube prosthesis Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; 34831 Open aortoiliac prosth repr aorto-bi-iliac prosthesis Page 18 of 30 CPT/ HCPCS Short Description Long Description Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; 34832 Open aortofemor prosth repr aorto-bifemoral prosthesis Open iliac artery exposure with creation of conduit for delivery of aortic or iliac endovascular prosthesis, by abdominal or retroperitoneal incision, 34833 Xpose for endoprosth iliac unilateral Open brachial artery exposure to assist in the deployment of aortic or 34834 Xpose endoprosth brachial iliac endovascular prosthesis by arm incision, unilateral Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery 34841 Endovasc visc aorta 1 graft endoprosthesis (superior mesenteric, celiac or renal artery) Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery 34842 Endovasc visc aorta 2 graft endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery 34843 Endovasc visc aorta 3 graft endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery 34844 Endovasc visc aorta 4 graft endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Page 19 of 30 CPT/ HCPCS Short Description Long Description Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal 34845 Visc & infraren abd 1 prosth artery) Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal 34846 Visc & infraren abd 2 prosth artery[s]) Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]) 34847 Visc & infraren abd 3 prosth Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or 34848 Visc & infraren abd 4+ prost renal artery[s]) Endovascular graft placement for repair of iliac artery (eg, aneurysm, 34900 Endovasc iliac repr w/graft pseudoaneurysm, arteriovenous malformation, trauma)

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and 35001 Repair defect of artery associated occlusive disease, carotid, subclavian artery, by neck incision Page 20 of 30 CPT/ HCPCS Short Description Long Description Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35002 Repair artery rupture neck carotid, subclavian artery, by neck incision Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, 35005 Repair defect of artery pseudoaneurysm, and associated occlusive disease, vertebral artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35013 Repair artery rupture arm axillary-brachial artery, by arm incision Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, innominate, 35021 Repair defect of artery subclavian artery, by thoracic incision Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35022 Repair artery rupture chest innominate, subclavian artery, by thoracic incision Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, 35081 Repair defect of artery pseudoaneurysm, and associated occlusive disease, abdominal aorta Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35082 Repair artery rupture aorta abdominal aorta Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta 35091 Repair defect of artery involving visceral vessels (mesenteric, celiac, ren

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35092 Repair artery rupture aorta abdominal aorta involving visceral vessels (mesenteric, celiac, renal) Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, abdominal aorta 35102 Repair defect of artery involving iliac vessels (common, hypogastric, exter

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35103 Repair artery rupture aorta abdominal aorta involving iliac vessels (common, hypogastric, external) Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, 35111 Repair defect of artery pseudoaneurysm, and associated occlusive disease, splenic artery Page 21 of 30 CPT/ HCPCS Short Description Long Description Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35112 Repair artery rupture spleen splenic artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, 35121 Repair defect of artery renal, or mesenteric artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35122 Repair artery rupture belly hepatic, celiac, renal, or mesenteric artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, iliac artery 35131 Repair defect of artery (common, hypogastric, external) Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35132 Repair artery rupture groin iliac artery (common, hypogastric, external) Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, common femoral 35141 Repair defect of artery artery (profunda femoris, superficial femoral)

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35142 Repair artery rupture thigh common femoral artery (profunda femoris, superficial femoral) Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, 35151 Repair defect of artery pseudoaneurysm, and associated occlusive disease, popliteal artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, 35152 Repair ruptd popliteal art popliteal artery 35182 Repair blood vessel lesion Repair, congenital arteriovenous fistula; thorax and abdomen

35189 Repair blood vessel lesion Repair, acquired or traumatic arteriovenous fistula; thorax and abdomen 35211 Repair blood vessel lesion Repair blood vessel, direct; intrathoracic, with bypass 35216 Repair blood vessel lesion Repair blood vessel, direct; intrathoracic, without bypass 35221 Repair blood vessel lesion Repair blood vessel, direct; intra-abdominal 35241 Repair blood vessel lesion Repair blood vessel with vein graft; intrathoracic, with bypass 35246 Repair blood vessel lesion Repair blood vessel with vein graft; intrathoracic, without bypass 35251 Repair blood vessel lesion Repair blood vessel with vein graft; intra-abdominal Page 22 of 30 CPT/ HCPCS Short Description Long Description

35271 Repair blood vessel lesion Repair blood vessel with graft other than vein; intrathoracic, with bypass Repair blood vessel with graft other than vein; intrathoracic, without 35276 Repair blood vessel lesion bypass 35281 Repair blood vessel lesion Repair blood vessel with graft other than vein; intra-abdominal Thromboendarterectomy, including patch graft, if performed; carotid, 35301 Rechanneling of artery vertebral, subclavian, by neck incision Thromboendarterectomy, including patch graft, if performed; superficial 35302 Rechanneling of artery femoral artery Thromboendarterectomy, including patch graft, if performed; popliteal 35303 Rechanneling of artery artery Thromboendarterectomy, including patch graft, if performed; 35304 Rechanneling of artery tibioperoneal trunk artery Thromboendarterectomy, including patch graft, if performed; tibial or 35305 Rechanneling of artery peroneal artery, initial vessel Thromboendarterectomy, including patch graft, if performed; each additional tibial or peroneal artery (List separately in addition to code for 35306 Rechanneling of artery primary procedure) Thromboendarterectomy, including patch graft, if performed; subclavian, 35311 Rechanneling of artery innominate, by thoracic incision Thromboendarterectomy, including patch graft, if performed; abdominal 35331 Rechanneling of artery aorta Thromboendarterectomy, including patch graft, if performed; mesenteric, 35341 Rechanneling of artery celiac, or renal 35351 Rechanneling of artery Thromboendarterectomy, including patch graft, if performed; iliac 35355 Rechanneling of artery Thromboendarterectomy, including patch graft, if performed; iliofemoral Thromboendarterectomy, including patch graft, if performed; combined 35361 Rechanneling of artery aortoiliac Thromboendarterectomy, including patch graft, if performed; combined 35363 Rechanneling of artery aortoiliofemoral Thromboendarterectomy, including patch graft, if performed; common 35371 Rechanneling of artery femoral Thromboendarterectomy, including patch graft, if performed; deep 35372 Rechanneling of artery (profunda) femoral Reoperation, carotid, thromboendarterectomy, more than one month after original operation (List separately in addition to code for primary 35390 Reoperation carotid add-on procedure) Angioscopy (non-coronary vessels or grafts) during therapeutic 35400 Angioscopy intervention (List separately in addition to code for primary procedure) 35501 Art byp grft ipsilat carotid Bypass graft, with vein; common carotid-ipsilateral internal carotid 35506 Art byp grft subclav-carotid Bypass graft, with vein; carotid-subclavian or subclavian-carotid Page 23 of 30 CPT/ HCPCS Short Description Long Description 35508 Art byp grft carotid-vertbrl Bypass graft, with vein; carotid-vertebral 35509 Art byp grft contral carotid Bypass graft, with vein; carotid-contralateral carotid 35510 Art byp grft carotid-brchial Bypass graft, with vein; carotid-brachial 35511 Art byp grft subclav-subclav Bypass graft, with vein; subclavian-subclavian 35512 Art byp grft subclav-brchial Bypass graft, with vein; subclavian-brachial 35515 Art byp grft subclav-vertbrl Bypass graft, with vein; subclavian-vertebral 35516 Art byp grft subclav-axilary Bypass graft, with vein; subclavian-axillary 35518 Art byp grft axillary-axilry Bypass graft, with vein; axillary-axillary 35521 Art byp grft axill-femoral Bypass graft, with vein; axillary-femoral 35522 Art byp grft axill-brachial Bypass graft, with vein; axillary-brachial 35523 Art byp grft brchl-ulnr-rdl Bypass graft, with vein; brachial-ulnar or -radial 35525 Art byp grft brachial-brchl Bypass graft, with vein; brachial-brachial 35526 Art byp grft aor/carot/innom Bypass graft, with vein; aortosubclavian or carotid 35531 Art byp grft aorcel/aormesen Bypass graft, with vein; aortoceliac or aortomesenteric 35533 Art byp grft axill/fem/fem Bypass graft, with vein; axillary-femoral-femoral 35535 Art byp grft hepatorenal Bypass graft, with vein; hepatorenal 35536 Art byp grft splenorenal Bypass graft, with vein; splenorenal 35537 Art byp grft aortoiliac Bypass graft, with vein; aortoiliac 35538 Art byp grft aortobi-iliac Bypass graft, with vein; aortobi-iliac 35539 Art byp grft aortofemoral Bypass graft, with vein; aortofemoral 35540 Art byp grft aortbifemoral Bypass graft, with vein; aortobifemoral 35556 Art byp grft fem-popliteal Bypass graft, with vein; femoral-popliteal 35558 Art byp grft fem-femoral Bypass graft, with vein; femoral-femoral 35560 Art byp grft aortorenal Bypass graft, with vein; aortorenal 35563 Art byp grft ilioiliac Bypass graft, with vein; ilioiliac 35565 Art byp grft iliofemoral Bypass graft, with vein; iliofemoral Bypass graft, with vein; femoral-anterior tibial, posterior tibial, peroneal 35566 Art byp fem-ant-post tib/prl artery or other distal vessels Bypass graft, with vein; tibial-tibial, peroneal-tibial, or tibial/peroneal 35570 Art byp tibial-tib/peroneal trunk-tibial Bypass graft, with vein; popliteal-tibial, -peroneal artery or other distal 35571 Art byp pop-tibl-prl-other vessels 35583 Vein byp grft fem-popliteal In-situ vein bypass; femoral-popliteal In-situ vein bypass; femoral-anterior tibial, posterior tibial, or peroneal 35585 Vein byp fem-tibial peroneal artery 35587 Vein byp pop-tibl peroneal In-situ vein bypass; popliteal-tibial, peroneal Harvest of upper extremity artery, one segment, for coronary artery 35600 Harvest art for cabg add-on bypass procedure Bypass graft, with other than vein; common carotid-ipsilateral internal 35601 Art byp common ipsi carotid carotid 35606 Art byp carotid-subclavian Bypass graft, with other than vein; carotid-subclavian Page 24 of 30 CPT/ HCPCS Short Description Long Description 35612 Art byp subclav-subclavian Bypass graft, with other than vein; subclavian-subclavian 35616 Art byp subclav-axillary Bypass graft, with other than vein; subclavian-axillary 35621 Art byp axillary-femoral Bypass graft, with other than vein; axillary-femoral 35623 Art byp axillary-pop-tibial Bypass graft, with other than vein; axillary-popliteal or -tibial 35626 Art byp grft aor/carot/innom Bypass graft, with other than vein; aortosubclavian or carotid Bypass graft, with other than vein; aortoceliac, aortomesenteric, 35631 Art byp aor-celiac-msn-renal aortorenal 35632 Art byp ilio-celiac Bypass graft, with other than vein; ilio-celiac 35633 Art byp ilio-mesenteric Bypass graft, with other than vein; ilio-mesenteric 35634 Art byp iliorenal Bypass graft, with other than vein; iliorenal Bypass graft, with other than vein; splenorenal (splenic to renal arterial 35636 Art byp spenorenal anastomosis) 35637 Art byp aortoiliac Bypass graft, with other than vein; aortoiliac 35638 Art byp aortobi-iliac Bypass graft, with other than vein; aortobi-iliac 35642 Art byp carotid-vertebral Bypass graft, with other than vein; carotid-vertebral 35645 Art byp subclav-vertebrl Bypass graft, with other than vein; subclavian-vertebral 35646 Art byp aortobifemoral Bypass graft, with other than vein; aortobifemoral 35647 Art byp aortofemoral Bypass graft, with other than vein; aortofemoral 35650 Art byp axillary-axillary Bypass graft, with other than vein; axillary-axillary 35654 Art byp axill-fem-femoral Bypass graft, with other than vein; axillary-femoral-femoral 35656 Art byp femoral-popliteal Bypass graft, with other than vein; femoral-popliteal 35661 Art byp femoral-femoral Bypass graft, with other than vein; femoral-femoral 35663 Art byp ilioiliac Bypass graft, with other than vein; ilioiliac 35665 Art byp iliofemoral Bypass graft, with other than vein; iliofemoral Bypass graft, with other than vein; femoral-anterior tibial, posterior tibial, 35666 Art byp fem-ant-post tib/prl or peroneal artery 35671 Art byp pop-tibl-prl-other Bypass graft, with other than vein; popliteal-tibial or -peroneal artery Bypass graft; composite, prosthetic and vein (List separately in addition 35681 Composite byp grft pros&vein to code for primary procedure) Bypass graft; autogenous composite, two segments of veins from two 35682 Composite byp grft 2 veins locations (List separately in addition to code for primary procedure) Bypass graft; autogenous composite, three or more segments of vein from two or more locations (List separately in addition to code for 35683 Composite byp grft 3/> segmt primary procedure) 35691 Art trnsposj vertbrl carotid Transposition and/or reimplantation; vertebral to carotid artery 35693 Art trnsposj subclavian Transposition and/or reimplantation; vertebral to subclavian artery 35694 Art trnsposj subclav carotid Transposition and/or reimplantation; subclavian to carotid artery 35695 Art trnsposj carotid subclav Transposition and/or reimplantation; carotid to subclavian artery Reimplantation, visceral artery to infrarenal aortic prosthesis, each artery 35697 Reimplant artery each (List separately in addition to code for primary procedure) Page 25 of 30 CPT/ HCPCS Short Description Long Description Reoperation, femoral-popliteal or femoral (popliteal)-anterior tibial, posterior tibial, peroneal artery, or other distal vessels, more than one month after original operation (List separately in addition to code for 35700 Reoperation bypass graft primary procedure) Exploration (not followed by surgical repair), with or without lysis of 35701 Exploration carotid artery artery; carotid artery Exploration (not followed by surgical repair), with or without lysis of 35721 Exploration femoral artery artery; femoral artery Exploration (not followed by surgical repair), with or without lysis of 35741 Exploration popliteal artery artery; popliteal artery

35800 Explore neck vessels Exploration for postoperative hemorrhage, thrombosis or infection; neck

35820 Explore chest vessels Exploration for postoperative hemorrhage, thrombosis or infection; chest Exploration for postoperative hemorrhage, thrombosis or infection; 35840 Explore abdominal vessels abdomen 35870 Repair vessel graft defect Repair of graft-enteric fistula 35901 Excision graft neck Excision of infected graft; neck 35905 Excision graft thorax Excision of infected graft; thorax 35907 Excision graft abdomen Excision of infected graft; abdomen 36660 Insertion catheter artery Catheterization, umbilical artery, newborn, for diagnosis or therapy Insertion of arterial and venous cannula(s) for isolated extracorporeal circulation including regional chemotherapy perfusion to an extremity, with or without hyperthermia, with removal of cannula(s) and repair of 36823 Insertion of cannula(s) arteriotomy and venotomy sites 37140 Revision of circulation Venous anastomosis, open; portocaval 37145 Revision of circulation Venous anastomosis, open; renoportal 37160 Revision of circulation Venous anastomosis, open; caval-mesenteric 37180 Revision of circulation Venous anastomosis, open; splenorenal, proximal Venous anastomosis, open; splenorenal, distal (selective decompression 37181 Splice spleen/kidney veins of esophagogastric varices, any technique) Insertion of transvenous intrahepatic portosystemic shunt(s) (TIPS) (includes venous access, hepatic and portal vein catheterization, portography with hemodynamic evaluation, intrahepatic tract 37182 Insert hepatic shunt (tips) formation/dilatation, stent placement and all associated imag Transcatheter placement of intravascular stent(s), cervical carotid artery, 37215 Transcath stent cca w/eps percutaneous; with distal embolic protection Page 26 of 30 CPT/ HCPCS Short Description Long Description

Transcatheter placement of an intravascular stent(s), intrathoracic common carotid artery or innominate artery by retrograde treatment, via open ipsilateral cervical carotid artery exposure, including angioplasty, 37217 Stent placemt retro carotid when performed, and radiological supervision and interpretation Transcatheter placement of intravascular stent(s), intrathoracic common carotid artery or innominate artery, open or percutaneous antegrade approach, including angioplasty, when performed, and radiological 37218 Stent placemt ante carotid supervision and interpretation 37616 Ligation of chest artery Ligation, major artery (eg, post-traumatic, rupture); chest 37617 Ligation of abdomen artery Ligation, major artery (eg, post-traumatic, rupture); abdomen 37618 Ligation of extremity artery Ligation, major artery (eg, post-traumatic, rupture); extremity 37660 Revision of major vein Ligation of common iliac vein 37788 Revascularization penis Penile revascularization, artery, with or without vein graft 38100 Removal of spleen total Splenectomy; total (separate procedure) 38101 Removal of spleen partial Splenectomy; partial (separate procedure) Splenectomy; total, en bloc for extensive disease, in conjunction with 38102 Removal of spleen total other procedure (List in addition to code for primary procedure) Repair of ruptured spleen (splenorrhaphy) with or without partial 38115 Repair of ruptured spleen splenectomy 38380 Thoracic duct procedure Suture and/or ligation of thoracic duct; cervical approach 38381 Thoracic duct procedure Suture and/or ligation of thoracic duct; thoracic approach 38382 Thoracic duct procedure Suture and/or ligation of thoracic duct; abdominal approach Limited lymphadenectomy for staging (separate procedure); pelvic and 38562 Removal pelvic lymph nodes para-aortic Removal abdomen lymph Limited lymphadenectomy for staging (separate procedure); 38564 nodes retroperitoneal (aortic and/or splenic) 38724 Removal of lymph nodes neck Cervical lymphadenectomy (modified radical neck dissection) Thoracic lymphadenectomy, regional, including mediastinal and peritracheal nodes (List separately in addition to code for primary 38746 Remove thoracic lymph nodes procedure) Abdominal lymphadenectomy, regional, including celiac, gastric, portal, Remove abdominal lymph peripancreatic, with or without para-aortic and vena caval nodes (List 38747 nodes separately in addition to code for primary procedure) Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator 38765 Remove groin lymph nodes nodes (separate procedure) Pelvic lymphadenectomy, including external iliac, hypogastric, and 38770 Remove pelvis lymph nodes obturator nodes (separate procedure) Remove abdomen lymph Retroperitoneal transabdominal lymphadenectomy, extensive, including 38780 nodes pelvic, aortic, and renal nodes (separate procedure) Page 27 of 30 CPT/ HCPCS Short Description Long Description Mediastinotomy with exploration, drainage, removal of foreign body, or 39000 Exploration of chest biopsy; cervical approach Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median 39010 Exploration of chest sternotomy 39200 Resect mediastinal cyst Excision of mediastinal cyst 39220 Resect mediastinal tumor Excision of mediastinal tumor 39499 Chest procedure Unlisted procedure, mediastinum 39501 Repair diaphragm laceration Repair, laceration of diaphragm, any approach Repair, neonatal diaphragmatic hernia, with or without chest tube 39503 Repair of diaphragm hernia insertion and with or without creation of ventral hernia 39540 Repair of diaphragm hernia Repair, diaphragmatic hernia (other than neonatal), traumatic; acute 39541 Repair of diaphragm hernia Repair, diaphragmatic hernia (other than neonatal), traumatic; chronic Imbrication of diaphragm for eventration, transthoracic or 39545 Revision of diaphragm transabdominal, paralytic or nonparalytic 39560 Resect diaphragm simple Resection, diaphragm; with simple repair (eg, primary suture) Resection, diaphragm; with complex repair (eg, prosthetic material, local 39561 Resect diaphragm complex muscle flap) 39599 Diaphragm surgery procedure Unlisted procedure, diaphragm Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and 75956 Xray endovasc thor ao repr interpretation Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological 75957 Xray endovasc thor ao repr supervision and interpretation Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption), 75958 Xray place prox ext thor ao radiological supervision and interpretation Placement of distal extension prosthesis(s) (delayed) after endovascular repair of descending thoracic aorta, as needed, to level of 75959 Xray place dist ext thor ao celiac origin, radiological supervision and interpretation Page 28 of 30 CPT/ HCPCS Short Description Long Description Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, 92941 Prq card revasc mi 1 vsl single vessel 92970 Cardioassist internal Cardioassist-method of circulatory assist; internal Cardioassist-method of circulatory assist; external 92971 Cardioassist external Thrombolysis, coronary; by intracoronary infusion, including selective 92975 Dissolve clot heart vessel coronary angiography Atrial septectomy or septostomy; transvenous method, balloon (eg, rashkind type) (includes cardiac catheterization) 92992 Revision of heart chamber Atrial septectomy or septostomy; transvenous method, balloon (eg, 92992 Revision of heart chamber rashkind type) (includes cardiac catheterization) Atrial septectomy or septostomy; blade method (park septostomy) 92993 Revision of heart chamber (includes cardiac catheterization)

Percutaneous transcatheter septal reduction therapy (eg, alcohol septal 93583 Perq transcath septal reduxn ablation) including temporary pacemaker insertion when performed Assembly and operation of pump with oxygenator or heat exchanger 99190 Special pump services (with or without ecg and/or pressure monitoring); each hour Assembly and operation of pump with oxygenator or heat exchanger 99191 Special pump services (with or without ecg and/or pressure monitoring); 45 minutes Assembly and operation of pump with oxygenator or heat exchanger 99192 Special pump services (with or without ecg and/or pressure monitoring); 30 minutes Transluminal peripheral atherectomy, open or percutaneous, including radiological supervision and interpretation; visceral artery (except renal), 0235T Trluml perip athrc visceral each vessel Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external and 0254T Evasc rpr iliac art bifur internal iliac artery, unilateral

Endovascular repair of iliac artery bifurcation (eg, aneurysm, pseudoaneurysm, arteriovenous malformation, trauma) using bifurcated endoprosthesis from the common iliac artery into both the external and 0255T Evasc rpr iliac art bifr s&i internal iliac artery, unilateral; radiological supervision and interpretation Implantation of catheter-delivered prosthetic pulmonary valve, 0262T Impltj pulm vlv evasc appr endovascular approach Page 29 of 30 CPT/ HCPCS Short Description Long Description Implantation or replacement of carotid sinus baroreflex activation device; total system (includes generator placement, unilateral or bilateral lead placement, intra-operative interrogation, programming, and 0266T Implt/rpl crtd sns dev total repositioning, when performed) Insertion of left atrial hemodynamic monitor; complete system, includes implanted communication module and pressure sensor lead in left atrium including transseptal access, radiological supervision and interpretation, 0293T Ins lt atrl press monitor and associated injection procedures, when performed Insertion of left atrial hemodynamic monitor; pressure sensor lead at time of insertion of pacing cardioverter-defibrillator pulse generator including radiological supervision and interpretation and associated injection procedures, when performed (list separately in addition to code 0294T Ins lt atrl mont pres lead for primary procedure) Transcatheter mitral valve repair percutaneous approach via the 0345T Transcath mtral vlve repair coronary sinus

Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; complete system (counterpulsation device, vascular graft, implantable vascular hemostatic 0451T Insj/rplcmt aortic ventr sys seal, mechano-electrical skin interface and subcutaneous electrodes) Insertion or replacement of a permanently implantable aortic counterpulsation ventricular assist system, endovascular approach, and programming of sensing and therapeutic parameters; aortic 0452T Insj/rplcmt dev vasc seal counterpulsation device and vascular hemostatic seal Removal of permanently implantable aortic counterpulsation ventricular assist system; complete system (aortic counterpulsation device, vascular hemostatic seal, mechano-electrical skin interface and electrodes) 0455T Remvl aortic ventr cmpl sys Removal of permanently implantable aortic counterpulsation ventricular assist system; aortic counterpulsation device and vascular hemostatic 0456T Remvl aortic dev vasc seal seal Relocation of skin pocket with replacement of implanted aortic counterpulsation ventricular assist device, mechano-electrical skin 0459T Relocaj rplcmt aortic ventr interface and electrodes Repositioning of previously implanted aortic counterpulsation ventricular 0461T Repos aortic contrpulsj dev assist device; aortic counterpulsation device Transcatheter mitral valve implantation/replacement (TMVI) with prosthetic valve; percutaneous approach, including transseptal puncture, 0483T Tmvi percutaneous approach when performed Page 30 of 30 CPT/ HCPCS Short Description Long Description Transcatheter mitral valve implantation/replacement (TMVI) with 0484T Tmvi transthoracic exposure prosthetic valve; transthoracic exposure (eg, thoracotomy, transapical) Surgical preparation and cannulation of marginal (extended) cadaver donor lung(s) to ex vivo organ perfusion system, including decannulation, separation from the perfusion system, and cold 0494T Prep & cannulj cdvr don lung preservation of the allograft prior to implantation, when performed Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including 0495T Mntr cdvr don lng 1st 2 hrs bronchoscopy and X ray when performed; first two hours in sterile field Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; each additional hour (List 0496T Mntr cdvr don lng ea addl hr separately in addition to code for primary procedure) Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including radiologic supervision and interpretation, 0075T Perq stent/chest vert art percutaneous Transcatheter placement of extracranial vertebral or intrathoracic carotid artery stent(s), including radiologic supervision and interpretation, 0076T S&i stent/chest vert art percutaneous Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when C9606 Perc d-e cor revasc w ami s performed, single vessel Page 1 of 13 Medicare IP Only List 2019 Digestive System CPT/ HCPCS Short Description Long Description Added to IP Only List Removed from IP Only List 47381 Open ablate liver tumor cryo Ablation, open, of one or more liver tumor(s); cryosurgical 47380 Open ablate liver tumor rf Ablation, open, of one or more liver tumor(s); radiofrequency 47760 Fuse bile ducts and bowel Anastomosis, of extrahepatic biliary ducts and gastrointestinal tract 47765 Fuse liver ducts & bowel Anastomosis, of intrahepatic ducts and gastrointestinal tract 47780 Fuse bile ducts and bowel Anastomosis, Roux-en-Y, of extrahepatic biliary ducts and gastrointestinal tract 47785 Fuse bile ducts and bowel Anastomosis, Roux-en-Y, of intrahepatic biliary ducts and gastrointestinal tract 46705 Repair of anal stricture Anoplasty, plastic operation for stricture; infant 44960 Appendectomy Appendectomy; for ruptured appendix with abscess or generalized peritonitis Backbench reconstruction of cadaver donor pancreas allograft prior to transplantation, venous 48552 Prep donor pancreas/venous anastomosis, each Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; 44721 Prep donor intestine/artery arterial anastomosis, each Backbench reconstruction of cadaver or living donor intestine allograft prior to transplantation; 44720 Prep donor intestine/venous venous anastomosis, each Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; arterial 47147 Prep donor liver/arterial anastomosis, each Backbench reconstruction of cadaver or living donor liver graft prior to allotransplantation; venous 47146 Prep donor liver/venous anastomosis, each Backbench standard preparation of cadaver donor pancreas allograft prior to transplantation, including dissection of allograft from surrounding soft tissues, splenectomy, duodenotomy, ligation 48551 Prep donor pancreas of bile duct, ligation of mesenteric vessels, and Y-graft arte Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to 47144 Prep donor liver 3-segment prepare the vena cava, portal vein, hepatic artery, and comm Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to 47145 Prep donor liver lobe split prepare the vena cava, portal vein, hepatic artery, and comm Backbench standard preparation of cadaver donor whole liver graft prior to allotransplantation, including cholecystectomy, if necessary, and dissection and removal of surrounding soft tissues to 47143 Prep donor liver whole prepare the vena cava, portal vein, hepatic artery, and comm Backbench standard preparation of cadaver or living donor intestine allograft prior to 44715 Prepare donor intestine transplantation, including mobilization and fashioning of the superior mesenteric artery and vein Biliary endoscopy, intraoperative (choledochoscopy) (List separately in addition to code for 47550 Bile duct endoscopy add-on primary procedure) 47100 Wedge biopsy of liver Biopsy of liver, wedge 48100 Biopsy of pancreas open Biopsy of pancreas, open (eg, fine needle aspiration, needle core biopsy, wedge biopsy) Page 2 of 13 CPT/ HCPCS Short Description Long Description 43605 Biopsy of stomach Biopsy of stomach; by laparotomy 47610 Removal of gallbladder Cholecystectomy with exploration of common duct; 47612 Removal of gallbladder Cholecystectomy with exploration of common duct; with choledochoenterostomy Cholecystectomy with exploration of common duct; with transduodenal sphincterotomy or 47620 Removal of gallbladder sphincteroplasty, with or without cholangiography 47600 Removal of gallbladder Cholecystectomy; 47605 Removal of gallbladder Cholecystectomy; with cholangiography 47720 Fuse gallbladder & bowel Cholecystoenterostomy; direct 47740 Fuse gallbladder & bowel Cholecystoenterostomy; Roux-en-Y 47741 Fuse gallbladder & bowel Cholecystoenterostomy; Roux-en-Y with gastroenterostomy 47721 Fuse upper gi structures Cholecystoenterostomy; with gastroenterostomy Cholecystotomy or cholecystostomy with exploration, drainage, or removal of calculus (separate 47480 Incision of gallbladder procedure) Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or 47425 Incision of bile duct without cholecystotomy; with transduodenal sphincterotomy or sphincteroplasty Choledochotomy or choledochostomy with exploration, drainage, or removal of calculus, with or 47420 Incision of bile duct without cholecystotomy; without transduodenal sphincterotomy or sphincteroplasty 44650 Repair bowel fistula Closure of enteroenteric or enterocolic fistula 44620 Repair bowel opening Closure of enterostomy, large or small intestine; Closure of enterostomy, large or small intestine; with resection and anastomosis other than 44625 Repair bowel opening colorectal Closure of enterostomy, large or small intestine; with resection and colorectal anastomosis (eg, 44626 Repair bowel opening closure of Hartmann type procedure) 44661 Repair bowel-bladder fistula Closure of enterovesical fistula; with intestine and/or bladder resection 44660 Repair bowel-bladder fistula Closure of enterovesical fistula; without intestinal or bladder resection 43425 Repair esophagus opening Closure of esophagostomy or fistula; transthoracic or transabdominal approach 43880 Repair stomach-bowel fistula Closure of gastrocolic fistula 44640 Repair bowel-skin fistula Closure of intestinal cutaneous fistula 45820 Repair rectourethral fistula Closure of rectourethral fistula; 45825 Repair fistula w/colostomy Closure of rectourethral fistula; with colostomy 45800 Repair rect/bladder fistula Closure of rectovesical fistula; 45805 Repair fistula w/colostomy Closure of rectovesical fistula; with colostomy 44160 Removal of colon Colectomy, partial, with removal of terminal ileum with ileocolostomy 44147 Partial removal of colon Colectomy, partial; abdominal and transanal approach 44140 Partial removal of colon Colectomy, partial; with anastomosis 44145 Partial removal of colon Colectomy, partial; with coloproctostomy (low pelvic anastomosis) 44146 Partial removal of colon Colectomy, partial; with coloproctostomy (low pelvic anastomosis), with colostomy

44143 Partial removal of colon Colectomy, partial; with end colostomy and closure of distal segment (Hartmann type procedure) 44144 Partial removal of colon Colectomy, partial; with resection, with colostomy or ileostomy and creation of mucofistula 44141 Partial removal of colon Colectomy, partial; with skin level cecostomy or colostomy Page 3 of 13 CPT/ HCPCS Short Description Long Description 44156 Removal of colon/ileostomy Colectomy, total, abdominal, with proctectomy; with continent ileostomy Colectomy w/nco-rectum Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, creation of ileal 44158 pouch reservoir (S or J), includes loop ileostomy, and rectal mucosectomy, when performed Colectomy, total, abdominal, with proctectomy; with ileoanal anastomosis, includes loop 44157 Colectomy w/ileoanal anast ileostomy, and rectal mucosectomy, when performed 44155 Removal of colon/ileostomy Colectomy, total, abdominal, with proctectomy; with ileostomy 44151 Removal of colon/ileostomy Colectomy, total, abdominal, without proctectomy; with continent ileostomy 44150 Removal of colon Colectomy, total, abdominal, without proctectomy; with ileostomy or ileoproctostomy 44320 Colostomy Colostomy or skin level cecostomy; Colostomy or skin level cecostomy; with multiple biopsies (eg, for congenital megacolon) 44322 Colostomy with biopsies (separate procedure) 44025 Incision of large bowel Colotomy, for exploration, biopsy(s), or foreign body removal 44316 Devise bowel pouch Continent ileostomy (Kock procedure) (separate procedure) Control of nasopharyngeal hemorrhage, primary or secondary (eg, postadenoidectomy); 42971 Control nose/throat bleeding complicated, requiring hospitalization Control oropharyngeal hemorrhage, primary or secondary (eg, post-tonsillectomy); complicated, 42961 Control throat bleeding requiring hospitalization Correction of malrotation by lysis of duodenal bands and/or reduction of midgut volvulus (eg, Ladd 44055 Correct malrotation of bowel procedure) 43135 Removal of esophagus pouch Diverticulectomy of hypopharynx or esophagus, with or without myotomy; thoracic approach 44132 Enterectomy cadaver donor Donor enterectomy (including cold preservation), open; from cadaver donor 44133 Enterectomy live donor Donor enterectomy (including cold preservation), open; partial, from living donor 47133 Removal of donor liver Donor hepatectomy (including cold preservation), from cadaver donor Donor hepatectomy (including cold preservation), from living donor; left lateral segment only 47140 Partial removal donor liver (segments II and III) Donor hepatectomy (including cold preservation), from living donor; total left lobectomy 47141 Partial removal donor liver (segments II, III and IV) Donor hepatectomy (including cold preservation), from living donor; total right lobectomy 47142 Partial removal donor liver (segments V, VI, VII and VIII) 49062 Drain to peritoneal cavity Drainage of extraperitoneal lymphocele to peritoneal cavity, open 49020 Drain abdominal abscess Drainage of peritoneal abscess or localized peritonitis, exclusive of appendiceal abscess; open 49060 Drain open retrop abscess Drainage of retroperitoneal abscess; open 49040 Drain open abdom abscess Drainage of subdiaphragmatic or subphrenic abscess; open 48547 Dnodenal exclusion Duodenal exclusion with gastrojejunostomy for pancreatic injury 44010 Incision of small bowel Duodenotomy, for exploration, biopsy(s), or foreign body removal Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; each additional resection and anastomosis (List separately in 44128 Enterectomy cong add-on addition to code for primary procedure) Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis 44127 Enterectomy w/taper cong of proximal segment of intestine; with tapering Page 4 of 13 CPT/ HCPCS Short Description Long Description Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis 44126 Enterectomy w/o taper cong of proximal segment of intestine; without tapering Enterectomy, resection of small intestine; each additional resection and anastomosis (List 44121 Removal of small intestine separately in addition to code for primary procedure) 44120 Removal of small intestine Enterectomy, resection of small intestine; single resection and anastomosis 44125 Removal of small intestine Enterectomy, resection of small intestine; with enterostomy Enteroenterostomy, anastomosis of intestine, with or without cutaneous enterostomy (separate 44130 Bowel to bowel fusion procedure) 44005 Freeing of bowel adhesion Enterolysis (freeing of intestinal adhesion) (separate procedure) 44300 Open bowel to skin Enterostomy or cecostomy, tube (eg, for decompression or feeding) (separate procedure) 44021 Decompress small bowel Enterotomy, small intestine, other than duodenum; for decompression (eg, Baker tube) Enterotomy, small intestine, other than duodenum; for exploration, biopsy(s), or foreign body 44020 Explore small intestine removal Esophageal lengthening procedure (eg, collis gastroplasty or wedge gastroplasty) (list separately 43338 Esoph lengthening in addition to code for primary procedure) 43327 Esoph fundoplasty lap Esophagogastric fundoplasty partial or complete; laparotomy 43328 Esoph fundoplasty thor Esophagogastric fundoplasty partial or complete; thoracotomy 43325 Revise esophagus & stomach Esophagogastric fundoplasty; with fundic patch (Thal-Nissen procedure) Pressure treatment 43460 esophagus Esophagogastric tamponade, with balloon (Sengstaaken type) Esophagogastrostomy (cardioplasty), with or without vagotomy and pyloroplasty, transabdominal 43320 Fuse esophagus & stomach or transthoracic approach 43340 Fuse esophagus & intestine Esophagojejunostomy (without total gastrectomy); abdominal approach 43341 Fuse esophagus & intestine Esophagojejunostomy (without total gastrectomy); thoracic approach 43330 Esophagomyotomy abdominal Esophagomyotomy (Heller type); abdominal approach 43331 Esophagomyotomy thoracic Esophagomyotomy (Heller type); thoracic approach Esophagoplasty (plastic repair or reconstruction), cervical approach; with repair of 43305 Repair esophagus and fistula tracheoesophageal fistula Esophagoplasty (plastic repair or reconstruction), cervical approach; without repair of 43300 Repair of esophagus tracheoesophageal fistula Esophagoplasty (plastic repair or reconstruction), thoracic approach; with repair of 43312 Repair esophagus and fistula tracheoesophageal fistula Esophagoplasty (plastic repair or reconstruction), thoracic approach; without repair of 43310 Repair of esophagus tracheoesophageal fistula Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; with 43314 Tracheo-esophagoplasty cong repair of congenital tracheoesophageal fistula Esophagoplasty for congenital defect (plastic repair or reconstruction), thoracic approach; without 43313 Esophagoplasty congenital repair of congenital tracheoesophageal fistula 47136 Surgical opening esophagus Esophagostomy, fistulization of esophagus, external; abdominal approach 43352 Surgical opening esophagus Esophagostomy, fistulization of esophagus, external; cervical approach 43351 Surgical opening esophagus Esophagostomy, fistulization of esophagus, external; thoracic approach Page 5 of 13 CPT/ HCPCS Short Description Long Description 43045 Incision of esophagus Esophagotomy, thoracic approach, with removal of foreign body 48148 Removal of pancrcatic duct Excision of ampulla of Vater 47711 Excision of bile duct tumor Excision of bile duct tumor, with or without primary repair of bile duct; extrahepatic 47712 Excision of bile duct tumor Excision of bile duct tumor, with or without primary repair of bile duct; intrahepatic 47715 Excision of bile duct cyst Excision of choledochal cyst 45136 Excise ileoanal reservior Excision of ileoanal reservoir with ileostomy 44820 Excision of mesentery lesion Excision of lesion of mesentery (separate procedure) 48120 Removal of pancreas lesion Excision of lesion of pancreas (eg, cyst, adenoma) 43100 Excision of esophagus lesion Excision of lesion, esophagus, with primary repair; cervical approach 43101 Excision of esophagus lesion Excision of lesion, esophagus, with primary repair; thoracic or abdominal approach 44800 Excision of bowel pouch Excision of Meckel's diverticulum (diverticulectomy) or omphalomesenteric duct Excision of one or more lesions of small or large intestine not requiring anastomosis, 44111 Excision of bowel lesion(s) exteriorization, or fistulization; multiple enterotomies Excision of one or more lesions of small or large intestine not requiring anastomosis, 44110 Excise intestine lesion(s) exteriorization, or fistulization; single enterotomy 42426 Excise parotid gland/lesion Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection 49215 Excise sacral spine tumor Excision of presacral or sacrococcygeal tumor 45135 Excision of rectal prolapse Excision of rectal procidentia, with anastomosis; abdominal and perineal approach 45130 Excision of rectal prolapse Excision of rectal procidentia, with anastomosis; perineal approach Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm 49203 Exc abd tum 5 cm or less diameter or less Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm 49204 Exc abd tum over 5 cm diameter Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 49205 Exc abd tum over 10 cm 10.0 cm diameter 43611 Excision of stomach lesion Excision, local; malignant tumor of stomach 43610 Excision of stomach lesion Excision, local; ulcer or benign tumor of stomach Exclusion of small intestine from pelvis by mesh or other prosthesis, or native tissue (eg, bladder 44700 Suspend bowel w/prosthesis or omentum) Exploration for congenital atresia of bile ducts, without repair, with or without liver biopsy, with or 47700 Exploration of bile ducts without cholangiography 45562 Exploration/repair of rectum Exploration, repair, and presacral drainage for rectal injury; 45563 Exploration/repair of rectum Exploration, repair, and presacral drainage for rectal injury; with colostomy 49010 Exploration behind abdomen Exploration, retroperitoneal area with or without biopsy(s) (separate procedure) 49000 Exploration of abdomen Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) 48510 Drain pancreatic pseudocyst External drainage, pseudocyst of pancreas; open 43496 Free jejunum flap microvasc Free jejunum transfer with microvascular anastomosis 49906 Free omental flap microvasc Free omental flap with microvascular anastomosis Page 6 of 13 CPT/ HCPCS Short Description Long Description 43634 Removal of stomach partial Gastrectomy, partial, distal; with formation of intestinal pouch 43631 Removal of stomach partial Gastrectomy, partial, distal; with gastroduodenostomy 43632 Removal of stomach partial Gastrectomy, partial, distal; with gastrojejunostomy 43633 Removal of stomach partial Gastrectomy, partial, distal; with Roux-en-Y reconstruction 43620 Removal of stomach Gastrectomy, total; with esophagoenterostomy 43622 Removal of stomach Gastrectomy, total; with formation of intestinal pouch, any type 43621 Removal of stomach Gastrectomy, total; with Roux-en-Y reconstruction Gastric restrictive procedure with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy (50 to 100 cm common channel) to limit absorption (biliopancreatic diversion with 43845 Gastroplasty duodenal switch duodenal switch) Gastric restrictive procedure, with gastric bypass for morbid obesity; with short limb (150 cm or 43846 Gastric bypass for obesity less) Roux-en-Y gastroenterostomy Gastric restrictive procedure, with gastric bypass for morbid obesity; with small intestine 43847 Gastric bypass incl small i reconstruction to limit absorption Gastric restrictive procedure, without gastric bypass, for morbid obesity; other than vertical- 43843 Gastroplasty w/o v-band banded gastroplasty 43810 Fusion of stomach and bowel Gastroduodenostomy Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or fistula, or for previous esophageal exclusion; with colon interposition or small intestine 43361 Gastrointestinal repair reconstruction, including intestine mobilization, preparation, and Gastrointestinal reconstruction for previous esophagectomy, for obstructing esophageal lesion or 43360 Gastrointestinal repair fistula, or for previous esophageal exclusion; with stomach, with or without pyloroplasty 43825 Fusion of stomach and bowel Gastrojejunostomy; with vagotomy, any type 43820 Fusion of stomach and bowel Gastrojejunostomy; without vagotomy 43840 Repair of stomach lesion Gastrorrhaphy, suture of perforated duodenal or gastric ulcer, wound, or injury 43832 Place gastrostomy tube Gastrostomy, open; with construction of gastric tube (eg, Janeway procedure) 43500 Surgical opening of stomach Gastrotomy; with exploration or foreign body removal 43501 Surgical repair of stomach Gastrotomy; with suture repair of bleeding ulcer 43502 Surgical repair of stomach Gastrotomy; with suture repair of pre-existing esophagogastric laceration (eg, Mallory-Weiss) Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck 41145 Tongue removal neck surgery dissection 41140 Removal of tongue Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection Glossectomy; composite procedure with resection floor of mouth and mandibular resection, 41150 Tongue mouth jaw surgery without radical neck dissection Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and 41155 Tongue jaw & neck surgery radical neck dissection (Commando type)

41153 Tongue mouth neck surgery Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection 41130 Partial removal of tongue Glossectomy; hemiglossectomy 41135 Tongue and neck surgery Glossectomy; partial, with unilateral radical neck dissection 47120 Partial removal of liver Hepatectomy, resection of liver; partial lobectomy Page 7 of 13 CPT/ HCPCS Short Description Long Description 47125 Partial removal of liver Hepatectomy, resection of liver; total left lobectomy 47130 Partial removal of liver Hepatectomy, resection of liver; total right lobectomy 47122 Extensive removal of liver Hepatectomy, resection of liver; trisegmentectomy 47400 Incision of liver duct Hepaticotomy or hepaticostomy with exploration, drainage, or removal of calculus 47010 Open drainage liver lesion Hepatotomy; for open drainage of abscess or cyst, one or two stages 44310 Ileostomy/jejunostomy Ileostomy or jejunostomy, non-tube 43881 Impl/redo electrd antrum Implantation or replacement of gastric neurostimulator electrodes, antrum, open 44900 Drain app abscess open Incision and drainage of appendiceal abscess; open Injection procedure for intraoperative pancreatography (List separately in addition to code for 48400 Injection intraop add-on primary procedure) 49425 Insert abdomen-venous drain Insertion of peritoneal-venous shunt

48520 Fuse pancreas cyst and bowel Internal anastomosis of pancreatic cyst to gastrointestinal tract; direct

48540 Fuse pancreas cyst and bowel Internal anastomosis of pancreatic cyst to gastrointestinal tract; Roux-en-Y 44135 Intestine transplnt cadaver Intestinal allotransplantation; from cadaver donor 44136 Intestine transplant live Intestinal allotransplantation; from living donor 44680 Surgical revision intestine Intestinal plication (separate procedure) Intestinal stricturoplasty (enterotomy and enterorrhaphy) with or without dilation, for intestinal 44615 Intestinal stricturoplasty obstruction Laparoscopy, surgical, closure of enterostomy, large or small intestine, with resection and 44227 Lap close enterostomy anastomosis 44188 Lap colostomy Laparoscopy, surgical, colostomy or skin level cecostomy Laparoscopy, surgical, esophageal lengthening procedure (eg, collis gastroplasty or wedge 43283 Lap esoph lengthening gastroplasty) (list separately in addition to code for primary procedure) 43279 Lap myotomy heller Laparoscopy, surgical, esophagomyotomy (Heller type), with fundoplasty, when performed Laparoscopy, surgical, gastric restrictive procedure; longitudinal gastrectomy (ie, sleeve 43775 Lap sleeve gastrectomy gastrectomy) Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric band 43771 Lap revise gastr adj device component only Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and Roux-en-Y 43644 Lap gastric bypass/roux-en-y gastroenterostomy (roux limb 150 cm or less) Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine 43645 Lap gastr bypass incl smll i reconstruction to limit absorption Laparoscopy, surgical, mobilization (take-down) of splenic flexure performed in conjunction with 44213 Lap mobil splenic fl add-on partial colectomy (list separately in addition to primary procedure)

47570 Laparo cholecystoenterostonry Laparoscopy, surgical; cholecystoenterostomy 44204 Laparo partial colectomy Laparoscopy, surgical; colectomy, partial, with anastomosis Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic 44207 L colectomy/coloproctostomy anastomosis) Page 8 of 13 CPT/ HCPCS Short Description Long Description Laparoscopy, surgical; colectomy, partial, with anastomosis, with coloproctostomy (low pelvic 44208 L colectomy/coloproctostomy anastomosis) with colostomy Laparoscopy, surgical; colectomy, partial, with end colostomy and closure of distal segment 44206 Lap part colectomy w/stoma (hartmann type procedure) 44205 Lap colectomy part w/ileum Laparoscopy, surgical; colectomy, partial, with removal of terminal ileum with ileocolostomy Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileoanal anastomosis, creation of ileal reservoir (S or J), with loop ileostomy, includes rectal mucosectomy, when 44211 Lap colectomy w/proctectomy performed 44212 Laparo total proctocolectomy Laparoscopy, surgical; colectomy, total, abdominal, with proctectomy, with ileostomy Laparoscopy, surgical; colectomy, total, abdominal, without proctectomy, with ileostomy or 44210 Laparo total proctocolectomy ileoproctostomy Laparoscopy, surgical; each additional small intestine resection and anastomosis (List separately 44203 Lap resect s/intestine addl in addition to code for primary procedure) Laparoscopy, surgical; enterectomy, resection of small intestine, single resection and 44202 Lap enterectomy anastomosis 44187 Lap ileo/jejuno-stomy Laparoscopy, surgical; ileostomy or jejunostomy, non-tube Laparoscopy, surgical; proctectomy, combined abdominoperineal pull-through procedure (eg, colo- anal anastomosis), with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy, 45397 Lap remove rectum w/pouch when performed 45395 Lap removal of rectum Laparoscopy, surgical; proctectomy, complete, combined abdominoperineal, with colostomy 45400 Laparoscopic proc Laparoscopy, surgical; proctopexy (for prolapse) 45402 Lap proctopexy w/sig resect Laparoscopy, surgical; proctopexy (for prolapse), with sigmoid resection Laparotomy, with aspiration and/or injection of hepatic parasitic (eg, amoebic or echinococcal) 47015 Inject/aspirate liver cyst cyst(s) or abscess(es) 49428 Ligation of shunt Ligation of peritoneal-venous shunt 43405 Ligate/staple esophagus Ligation or stapling at gastroesophageal junction for pre-existing esophageal perforation 43400 Ligate esophagus veins Ligation, direct, esophageal varices 47136 Transplantation of liver Liver allotransplantation; heterotopic, partial or whole, from cadaver or living donor, any age 47135 Transplantation of liver Liver allotransplantation; orthotopic, partial or whole, from cadaver or living donor, any age Management of liver hemorrhage; complex suture of liver wound or injury, with or without hepatic 47360 Repair liver wound artery ligation Management of liver hemorrhage; exploration of hepatic wound, extensive debridement, 47361 Repair liver wound coagulation and/or suture, with or without packing of liver 47362 Repair liver wound Management of liver hemorrhage; re-exploration of hepatic wound for removal of packing 47350 Repair liver wound Management of liver hemorrhage; simple suture of liver wound or injury 47300 Surgery for liver lesion Marsupialization of cyst or abscess of liver 48500 Surgery of pancreatic cyst Marsupialization of pancreatic cyst Mobilization (take-down) of splenic flexure performed in conjunction with partial colectomy (List 44139 Mobilization of colon separately in addition to primary procedure) 49904 Omental flap extra-abdom Omental flap, extra-abdominal (eg, for reconstruction of sternal and chest wall defects) 49905 Omental flap intra-abdom Omental flap, intra-abdominal (List separately in addition to code for primary procedure) Page 9 of 13 CPT/ HCPCS Short Description Long Description 49255 Removal of omentum Omentectomy, epiploectomy, resection of omentum (separate procedure) 48145 Partial removal of pancreas Pancreatectomy, distal subtotal, with or without splenectomy; with pancreaticojejunostomy 48140 Partial removal of pancreas Pancreatectomy, distal subtotal, with or without splenectomy; without pancreaticojejunostomy 48146 Pancreatectomy Pancreatectomy, distal, near-total with preservation of duodenum (Child-type procedure) Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and 48153 Pancreatectomy duodenojejunostomy (pylorus-sparing, Whipple-type procedure); with pancreatojejunostomy Pancreatectomy, proximal subtotal with near-total duodenectomy, choledochoenterostomy and 48154 Pancreatectomy duodenojejunostomy (pylorus-sparing, Whipple-type procedure); without pancreatojejunostomy Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); with 48150 Partial removal of pancreas pancreatojejunostomy Pancreatectomy, proximal subtotal with total duodenectomy, partial gastrectomy, choledochoenterostomy and gastrojejunostomy (Whipple-type procedure); without 48152 Pancreatectomy pancreatojejunostomy 48155 Removal of pancreas Pancreatectomy, total 48548 Fuse pancreas and bowel Pancreaticojejunostomy, side-to-side anastomosis (Puestow-type operation) 48545 Pancreatorrhaphy Pancreatorrhaphy for injury Partial esophagectomy, cervical, with free intestinal graft, including microvascular anastomosis, 43116 Partial removal of esophagus obtaining the graft and intestinal reconstruction Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, 43118 Partial removal of esophagus including intestine mobilization, preparation, and anastomosis(es Partial esophagectomy, distal two-thirds, with thoracotomy and separate abdominal incision, with or without proximal gastrectomy; with thoracic esophagogastrostomy, with or without pyloroplasty 43117 Partial removal of esophagus (Ivor Lewis) Partial esophagectomy, distal two-thirds, with thoracotomy only, with or without proximal 43121 Partial removal of esophagus gastrectomy, with thoracic esophagogastrostomy, with or without pyloroplasty Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal gastrectomy; with colon interposition or small intestine reconstruction, including intestine 43123 Partial removal of esophagus mobilization, preparation, and anastomosis(es) Partial esophagectomy, thoracoabdominal or abdominal approach, with or without proximal 43122 Partial removal of esophagus gastrectomy; with esophagogastrostomy, with or without pyloroplasty Esophagectomy, total or near total, with laparoscopic mobilization of the abdominal and mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, laparoscopic 43286 Esphg tot w/laps moblj transhiatal esophagectomy) Esophagectomy, distal two-thirds, with laparoscopic mobilization of the abdominal and lower mediastinal esophagus and proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with separate thoracoscopic mobilization of the middle and upper mediastinal esophagus and thoracic esophagogastrostomy (ie, laparoscopic thoracoscopic esophagectomy, 43287 Esphg dstl 2/3 w/laps moblj Ivor Lewis esophagectomy) Page 10 of 13 CPT/ HCPCS Short Description Long Description Esophagectomy, total or near total, with thoracoscopic mobilization of the upper, middle, and lower mediastinal esophagus, with separate laparoscopic proximal gastrectomy, with laparoscopic pyloric drainage procedure if performed, with open cervical pharyngogastrostomy or esophagogastrostomy (ie, thoracoscopic, laparoscopic and cervical incision esophagectomy, 43288 Esphg thrsc moblj McKeown esophagectomy, tri-incisional esophagectomy). Pelvic exenteration for colorectal malignancy, with proctectomy (with or without colostomy), with removal of bladder and ureteral transplantations, and/or hysterectomy, or cervicectomy, with or 45126 Pelvic exenteration without removal of tube(s), with or without removal of ovary( 42953 Repair throat esophagus Pharyngoesophageal repair 47801 Placement bile duct support Placement of choledochal stent 48000 Drainage of abdomen Placement of drains, peripancreatic, for acute pancreatitis; Placement of drains, peripancreatic, for acute pancreatitis; with cholecystostomy, gastrostomy, 48001 Placement of drain pancreas and jejunostomy

Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), open, intra-abdominal, intrapelvic, and/or retroperitoneum, including image guidance, if 49412 Ins device for rt guide open performed, single or multiple (list separately in addition to code for primary procedure) 47701 Bile duct revision Portoenterostomy (eg, Kasai procedure) Proctectomy, combined abdominoperineal pull-through procedure (eg, colo-anal anastomosis), 45119 Remove rectum w/reservoir with creation of colonic reservoir (eg, J-pouch), with diverting enterostomy when performed 45112 Removal of rectum Proctectomy, combined abdominoperineal, pull-through procedure (eg, colo-anal anastomosis) Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with pull- 45120 Removal of rectum through procedure and anastomosis (eg, Swenson, Duhamel, or Soave type operation) Proctectomy, complete (for congenital megacolon), abdominal and perineal approach; with 45121 Removal of rectum and colon subtotal or total colectomy, with multiple biopsies 45114 Partial removal of rectum Proctectomy, partial, with anastomosis; abdominal and transsacral approach 45116 Partial removal of rectum Proctectomy, partial, with anastomosis; transsacral approach only (Kraske type) Proctectomy, partial, with rectal mucosectomy, ileoanal anastomosis, creation of ileal reservoir (S 45113 Partial proctectomy or J), with or without loop ileostomy 45123 Partial proctectomy Proctectomy, partial, without anastomosis, perineal approach 45110 Removal of rectum Proctectomy; complete, combined abdominoperineal, with colostomy 45111 Partial removal of rectum Proctectomy; partial resection of rectum, transabdominal approach 45540 Correct rectal prolapse Proctopexy (eg, for prolapse); abdominal approach

45550 Repair rectum/remove sigmoid Proctopexy (eg, for prolapse); with sigmoid resection, abdominal approach 43520 Incision of pyloric muscle Pyloromyotomy, cutting of pyloric muscle (Fredet-Ramstedt type operation) 43800 Reconstruction of pylorus Pyloroplasty 42845 Extensive surgery of throat Radical resection of tonsil, tonsillar pillars, and/or retromolar trigone; closure with other flap 47800 Reconstruction of bile ducts Reconstruction, plastic, of extrahepatic biliary ducts with end-to-end anastomosis 44050 Reduce bowel obstruction Reduction of volvulus, intussusception, internal hernia, by laparotomy 48020 Removal of pancreatic stone Removal of pancreatic calculus Page 11 of 13 CPT/ HCPCS Short Description Long Description 44137 Remove intestinal allograft Removal of transplanted intestinal allograft, complete 48556 Removal allograft pancreas Removal of transplanted pancreatic allograft 49002 Reopening of abdomen Reopening of recent laparotomy Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and 46746 Repair of cloacal anomaly sacroperineal approach; Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, combined abdominal and 46748 Repair of cloacal anomaly sacroperineal approach; with vaginal lengthening by intestinal graft or pedicle flaps 46744 Repair of cloacal anomaly Repair of cloacal anomaly by anorectovaginoplasty and urethroplasty, sacroperineal approach Repair of high imperforate anus with rectourethral or rectovaginal fistula; combined 46742 Repair of imperforated anus transabdominal and sacroperineal approaches Repair of high imperforate anus with rectourethral or rectovaginal fistula; perineal or sacroperineal 46740 Construction of absent anus approach Repair of high imperforate anus without fistula; combined transabdominal and sacroperineal 46735 Construction of absent anus approaches 46730 Construction of absent anus Repair of high imperforate anus without fistula; perineal or sacroperineal approach Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; combined 46712 Repl per/vag pouch dbl proc transperineal and transabdominal approach Repair of ileoanal pouch fistula/sinus (eg, perineal or vaginal), pouch advancement; transperineal 46710 Repr per/vag pouch sngl proc approach 49605 Repair umbilical lesion Repair of large omphalocele or gastroschisis; with or without prosthesis Repair of large omphalocele or gastroschisis; with removal of prosthesis, final reduction and 49606 Repair umbilical lesion closure, in operating room 46715 Rep perf anoper fistu Repair of low imperforate anus; with anoperineal fistula (cut-back procedure) 46716 Rep perf anoper/vestib fistu Repair of low imperforate anus; with transposition of anoperineal or anovestibular fistula 49610 Repair umbilical lesion Repair of omphalocele (Gross type operation); first stage 49611 Repair umbilical lesion Repair of omphalocele (Gross type operation); second stage Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; 43333 Transab esoph hiat hern rpr with implantation of mesh or other prosthesis Repair, paraesophageal hiatal hernia (including fundoplication), via laparotomy, except neonatal; 43332 Transab esoph hiat hem rpr without implantation of mesh or other prosthesis Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; 43335 Transthor diaphrag hern rpr with implantation of mesh or other prosthesis Repair, paraesophageal hiatal hernia (including fundoplication), via thoracotomy, except neonatal; 43334 Transthor diaphrag hern rpr without implantation of mesh or other prosthesis Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, 43337 Thorabd diaphr hern repair except neonatal; with implantation of mesh or other prosthesis Repair, paraesophageal hiatal hernia, (including fundoplication), via thoracoabdominal incision, 43336 Thorabd diaphr hern repair except neonatal; without implantation of mesh or other prosthesis 42894 Revision of pharyngeal walls Resection of pharyngeal wall requiring closure with myocutaneous flap

48105 Resect/debride pancreas Resection or debridement of pancreas and peripancreatic tissue for acute necrotizing pancreatitis Page 12 of 13 CPT/ HCPCS Short Description Long Description 44345 Revision of colostomy Revision of colostomy; complicated (reconstruction in-depth) (separate procedure) 44346 Revision of colostomy Revision of colostomy; with repair of paracolostomy hernia (separate procedure) Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; with 43855 Revise stomach-bowel fusion vagotomy Revision of gastroduodenal anastomosis (gastroduodenostomy) with reconstruction; without 43850 Revise stomach-bowel fusion vagotomy Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without 43865 Revise stomach-bowel fusion partial gastrectomy or intestine resection; with vagotomy Revision of gastrojejunal anastomosis (gastrojejunostomy) with reconstruction, with or without 43860 Revise stomach-bowel fusion partial gastrectomy or intestine resection; without vagotomy 44314 Revision of ileostomy Revision of ileostomy; complicated (reconstruction in-depth) (separate procedure) 43882 Revise/remove electrd antrum Revision or removal of gastric neurostimulator electrodes, antrum, open Revision, open, of gastric restrictive procedure for morbid obesity, other than adjustable gastric 43848 Revision gastroplasty band (separate procedure) 46751 Repair of anal sphincter Sphincteroplasty, anal, for incontinence or prolapse; child Staging laparotomy for Hodgkins disease or lymphoma (includes splenectomy, needle or open biopsies of both liver lobes, possibly also removal of abdominal nodes, abdominal node and/or 49220 Multiple surgery abdomen bone marrow biopsies, ovarian repositioning) 43410 Repair esophagus wound Suture of esophageal wound or injury; cervical approach 43415 Repair esophagus wound Suture of esophageal wound or injury; transthoracic or transabdominal approach 47900 Suture bile duct injury Suture of extrahepatic biliary duct for pre-existing injury (separate procedure) Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture 44605 Repair of bowel lesion (single or multiple perforations); with colostomy Suture of large intestine (colorrhaphy) for perforated ulcer, diverticulum, wound, injury or rupture 44604 Suture large intestine (single or multiple perforations); without colostomy 44850 Repair of mesentery Suture of mesentery (separate procedure) Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or 44603 Suture small intestine rupture; multiple perforations Suture of small intestine (enterorrhaphy) for perforated ulcer, diverticulum, wound, injury or 44602 Suture small intestine rupture; single perforation 49900 Repair of abdominal wall Suture, secondary, of abdominal wall for evisceration or dehiscence Total or near total esophagectomy, with thoracotomy; with colon interposition or small intestine 43113 Removal of esophagus reconstruction, including intestine mobilization, preparation, and anastomosis(es) Total or near total esophagectomy, with thoracotomy; with pharyngogastrostomy or cervical 43112 Removal of esophagus esophagogastrostomy, with or without pyloroplasty Total or near total esophagectomy, without thoracotomy; with colon interposition or small intestine 43108 Removal of esophagus reconstruction, including intestine mobilization, preparation and anastomosis(es) Total or near total esophagectomy, without thoracotomy; with pharyngogastrostomy or cervical 43107 Removal of esophagus esophagogastrostomy, with or without pyloroplasty (transhiatal) Total or partial esophagectomy, without reconstruction (any approach), with cervical 43124 Removal of esophagus esophagostomy Page 13 of 13 CPT/ HCPCS Short Description Long Description Transduodenal sphincterotomy or sphincteroplasty, with or without transduodenal extraction of 47460 Incise bile duct sphincter calculus (separate procedure) 43401 Esophagus surgery for veins Transection of esophagus with repair, for esophageal varices 48554 Transpl allograft pancreas Transplantation of pancreatic allograft Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method (List 44015 Insert needle cath bowel separately in addition to primary procedure) 44899 Bowel surgery procedure Unlisted procedure, Meckel's diverticulum and the mesentery 47802 Fuse liver duct & intestine U-tube hepaticoenterostomy 43641 Vagotomy & pylorus repair Vagotomy including pyloroplasty, with or without gastrostomy; parietal cell (highly selective) 43640 Vagotomy & pylorus repair Vagotomy including pyloroplasty, with or without gastrostomy; truncal or selective Vagotomy when performed with partial distal gastrectomy (List separately in addition to code(s) 43635 Removal of stomach partial for primary procedure) Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction (EGJ), 0312T Laps impltj nstim vagus with implantation of pulse generator, includes programming Vagus nerve blocking therapy (morbid obesity); laparoscopic implantation of neurostimulator electrode array, anterior and posterior vagal trunks adjacent to esophagogastric junction (EGJ), 0312T Laps impltj nstim vagus with implantation of pulse generator, includes programming Page 1 of 1 Medicare IP Only List 2019 Endocrine Auditory ENT CPT/ HCPCS Short Description Long Description Removal of lymph 38724 nodes neck Cervical lymphadenectomy (modified radical neck dissection) Extensive thyroid 60254 surgery Thyroidectomy, total or subtotal for malignancy; with radical neck dissection 60270 Removal of thyroid Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach Explore parathyroid Parathyroidectomy or exploration of parathyroid(s); with mediastinal exploration, sternal split or transthoracic 60505 glands approach Removal of thymus Thymectomy, partial or total; sternal split or transthoracic approach, without radical mediastinal dissection 60521 gland (separate procedure) Removal of thymus Thymectomy, partial or total; sternal split or transthoracic approach, with radical mediastinal dissection 60522 gland (separate procedure) Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, 60540 Explore adrenal gland lumbar or dorsal (separate procedure); Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, 60545 Explore adrenal gland lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor Remove carotid body 60600 lesion Excision of carotid body tumor; without excision of carotid artery Remove carotid body 60605 lesion Excision of carotid body tumor; with excision of carotid artery Laparoscopy Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without 60650 adrenalectomy biopsy, transabdominal, lumbar or dorsal Extensive ear/neck 69155 surgery Radical excision external auditory canal lesion; with neck dissection Remove part of 69535 temporal bone Resection temporal bone, external approach 69554 Remove ear lesion Excision aural glomus tumor; extended (extratemporal) 69950 Incise inner ear nerve Vestibular nerve section, transcranial approach Percutaneous islet G0341 celltrans Percutaneous islet cell transplant, includes portal vein catheterization and infusion Laparoscopy islet cell G0342 trans Laparoscopy for islet cell transplant, includes portal vein catheterization and infusion Laparotomy islet cell G0343 transp Laparotomy for islet cell transplant, includes portal vein catheterization and infusion Page 1 of 1 Medicare IP Only List 2019 Eye and Ocular Adnexa CPT/ Short HCPCS Description Long Description Repair of eye 65273 wound Repair of laceration; conjunctiva, by mobilization and rearrangement, with hospitalization Page 1 of 4 Medicare IP Only List 2019 Female Genital System IP Only CPT/ HCPCS Short Description Long Description Added to IP Only List Extensive vulva 56630 surgery Vulvectomy, radical, partial; Extensive vulva 56631 surgery Vulvectomy, radical, partial; with unilateral inguinofemoral lymphadenectomy Extensive vulva 56632 surgery Vulvectomy, radical, partial; with bilateral inguinofemoral lymphadenectomy Extensive vulva 56633 surgery Vulvectomy, radical, complete; Extensive vulva 56634 surgery Vulvectomy, radical, complete; with unilateral inguinofemoral lymphadenectomy Extensive vulva 56637 surgery Vulvectomy, radical, complete; with bilateral inguinofemoral lymphadenectomy Extensive vulva 56640 surgery Vulvectomy, radical, complete, with inguinofemoral, iliac, and pelvic lymphadenectomy Remove vagina wall 57110 complete Vaginectomy, complete removal of vaginal wall; Remove vagina Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical 57111 tissue compl vaginectomy) Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical Vaginectomy vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling 57112 w/nodes compl (biopsy) Repair of bowel 57270 pouch Repair of enterocele, abdominal approach (separate procedure) Suspension of 57280 vagina Colpopexy, abdominal approach Revise vag graft 57296 open abd Revision (including removal) of prosthetic vaginal graft; open abdominal approach Repair rectum- 57305 vagina fistula Closure of rectovaginal fistula; abdominal approach Fistula repair & 57307 colostomy Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy Fistula repair Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or 57308 transpcrinc without levator plication

Repair 57311 urethrovaginal lesion Closure of urethrovaginal fistula; with bulbocavernosus transplant Page 2 of 4 Added to IP Only List Removal of cervix Radical trachelectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node 57531 radical sampling biopsy, with or without removal of tube(s), with or without removal of ovary(s) Removal of residual 57540 cervix Excision of cervical stump, abdominal approach; Remove 57545 cervix/repair pelvis Excision of cervical stump, abdominal approach; with pelvic floor repair Myomectomy abdom Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 58140 method 250 g or less and/or removal of surface myomas; abdominal approach Myomectomy abdom Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural 58146 complex myomas with total weight greater than 250 g, abdominal approach Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or 58150 Total hysterectomy without removal of ovary(s); Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or 58152 Total hysterectomy without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch) Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), 58180 Partial hysterectomy with or without removal of ovary(s) Extensive Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph 58200 hysterectomy node sampling, with or without removal of tube(s), with or without removal of ovary(s)

Extensive Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph 58210 hysterectomy node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s) Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, Removal of pelvis with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and 58240 contents ureteral transplantations, and/or abdominoperineal rese Vag hyst w/urinary Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti- 58267 repair Krantz type, Pereyra type) with or without endoscopic control Hysterectomy/revise 58275 vagina Vaginal hysterectomy, with total or partial vaginectomy; Hysterectomy/revise 58280 vagina Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele Extensive 58285 hysterectomy Vaginal hysterectomy, radical (Schauta type operation) Vag hyst w/uro Vaginal hysterectomy, for uterus greater than 250 g; with colpo-urethrocystopexy (Marshall- 58293 repair compl Marchetti-Krantz type, Pereyra type) with or without endoscopic control Suspension of Uterine suspension, with or without shortening of round ligaments, with or without shortening of 58400 uterus sacrouterine ligaments; (separate procedure) Suspension of Uterine suspension, with or without shortening of round ligaments, with or without shortening of 58410 uterus sacrouterine ligaments; with presacral sympathectomy Repair of ruptured 58520 uterus Hysterorrhaphy, repair of ruptured uterus (nonobstetrical) 58540 Revision of uterus Hysteroplasty, repair of uterine anomaly (Strassman type) Page 3 of 4 Added to IP Only List Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and 58548 Lap radical hyst para-aortic lymph node sampling (biopsy), with removal of tube(s) and ovary(s), if performed Lap tota hyst resj Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with 58575 mal omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed Division of fallopian Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or 58605 tube bilateral, during same hospitalization (separate procedure) Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra- Ligate oviduct(s) add-abdominal surgery (not a separate procedure) (List separately in addition to code for primary 58611 on procedure) Removal of fallopian 58700 tube Salpingectomy, complete or partial, unilateral or bilateral (separate procedure) Removal of 58720 ovary/tube(s) Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure) Adhesiolysis tube 58740 ovary Lysis of adhesions (salpingolysis, ovariolysis) 58750 Repair oviduct Tubotubal anastomosis Revise ovarian 58752 tube(s) Tubouterine implantation 58760 Fimbrioplasty Fimbrioplasty Drain ovary abscess 58822 percut Drainage of ovarian abscess; abdominal approach Transposition 58825 ovary(s) Transposition, ovary(s) 58940 Removal of ovary(s) Oophorectomy, partial or total, unilateral or bilateral; Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal 58943 Removal of ovary(s) biopsies, diaphragmatic assessments, with or without salpingecto Resect ovarian Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo- 58950 malignancy oophorectomy and omentectomy; Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo- Resect ovarian oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic 58951 malignancy lymphadenectomy Resection (initial) of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo- Resect ovarian oophorectomy and omentectomy; with radical dissection for debulking (ie, radical excision or 58952 malignancy destruction, intra-abdominal or retroperitoneal tumors) Tah rad dissect for Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical 58953 debulk dissection for debulking; Tah rad debulk/lymph Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical 58954 remove dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy Page 4 of 4 Added to IP Only List Bso omentectomy Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for 58956 w/tah malignancy Resect recurrent gyn Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy 58957 mal (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; Resection (tumor debulking) of recurrent ovarian, tubal, primary peritoneal, uterine malignancy Resect recur gyn (intra-abdominal, retroperitoneal tumors), with omentectomy, if performed; with pelvic 58958 mal w/lym lymphadenectomy and limited para-aortic lymphadenectomy Laparotomy, for staging or restaging of ovarian, tubal, or primary peritoneal malignancy (second Exploration of look), with or without omentectomy, peritoneal washing, biopsy of abdominal and pelvic 58960 abdomen peritoneum, diaphragmatic assessment with pelvic and limited para-aorti Page 1 of 1 Medicare IP Only List 2019 Integumentary System CPT/ HCPCS Short Description Long Description Debride genitalia & Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external 11004 perineum genitalia and perineum Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; 11005 Debride abdom wall abdominal wall, with or without fascial closure Debride Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external 11006 genit/per/abdom wall genitalia, perineum and abdominal wall, with or without fascial closure Remove mesh from abd Removal of prosthetic material or mesh, abdominal wall for necrotizing soft tissue infection (List 11008 wall separately in addition to code for primary procedure) Free myo/skin flap 15756 microvasc Free muscle or myocutaneous flap with microvascular anastomosis

15757 Free skin flap microvasc Free skin flap with microvascular anastomosis Free fascial flap 15758 microvasc Free fascial flap with microvascular anastomosis Escharotomy addl 16036 incision Escharotomy; each additional incision (List separately in addition to code for primary procedure) Excision of chest wall tumor involving ribs, with plastic reconstruction; without mediastinal 19271 Revision of chest wall lymphadenectomy Extensive chest wall 19272 surgery Excision of chest wall tumor involving ribs, with plastic reconstruction; with mediastinal lymphadenectomy 19305 Mast radical Mastectomy, radical, including pectoral muscles, axillary lymph nodes Mastectomy, radical, including pectoral muscles, axillary and internal mammary lymph nodes (Urban type 19306 Mast rad urban type operation) Breast reconstr w/lat 19361 flap Breast reconstruction with latissimus dorsi flap, without prosthetic implant 19364 Breast reconstruction Breast reconstruction with free flap Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, 19367 Breast reconstruction including closure of donor site; Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), single pedicle, 19368 Breast reconstruction including closure of donor site; with microvascular anastomosis (supercharging) Breast reconstruction with transverse rectus abdominis myocutaneous flap (TRAM), double pedicle, 19369 Breast reconstruction including closure of donor site Page 1 of 5 Medicare IP Only List 2019 Male Genital System CPT/ HCPCS Short Description Long Description Removed from IP Only list 50010 Exploration of kidney Renal exploration, not necessitating other specific procedures 50040 Drainage of kidney Nephrostomy, nephrotomy with drainage 50045 Exploration of kidney Nephrotomy, with exploration 50060 Removal of kidney stone Nephrolithotomy; removal of calculus 50065 Incision of kidney Nephrolithotomy; secondary surgical operation for calculus 50070 Incision of kidney Nephrolithotomy; complicated by congenital kidney abnormality Nephrolithotomy; removal of large staghorn calculus filling renal pelvis 50075 Removal of kidney stone and calyces (including anatrophic pyelolithotomy) Transection or repositioning of aberrant renal vessels (separate 50100 Revise kidney blood vessels procedure) 50120 Exploration of kidney Pyelotomy; with exploration 50125 Explore and drain kidney Pyelotomy; with drainage, pyelostomy Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, 50130 Removal of kidney stone including coagulum pyelolithotomy) Pyelotomy; complicated (eg, secondary operation, congenital kidney 50135 Exploration of kidney abnormality) 50205 Renal biopsy open Renal biopsy; by surgical exposure of kidney Nephrectomy, including partial ureterectomy, any open approach 50220 Remove kidney open including rib resection; Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on 50225 Removal kidney open complex same kidney Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or 50230 Removal kidney open radical vena caval thrombectomy Nephrectomy with total ureterectomy and bladder cuff; through same 50234 Removal of kidney & ureter incision Nephrectomy with total ureterectomy and bladder cuff; through 50236 Removal of kidney & ureter separate incision 50240 Partial removal of kidney Nephrectomy, partial Ablation, open, one or more renal mass lesion(s), cryosurgical, 50250 Cryoablate renal mass open including intraoperative ultrasound, if performed 50280 Removal of kidney lesion Excision or unroofing of cyst(s) of kidney 50290 Removal of kidney lesion Excision of perinephric cyst Donor nephrectomy (including cold preservation); from cadaver donor, 50300 Remove cadaver donor kidney unilateral or bilateral Page 2 of 5 Removed from IP Only list Donor nephrectomy (including cold preservation); open, from living 50320 Remove kidney living donor donor Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal 50323 Prep cadaver renal allograft gland, and preparation of ureter(s), renal ve Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal 50325 Prep donor renal graft artery(s), ligating branches, as nec Backbench reconstruction of cadaver or living donor renal allograft 50327 Prep renal graft/venous prior to transplantation; venous anastomosis, each Backbench reconstruction of cadaver or living donor renal allograft 50328 Prep renal graft/arterial prior to transplantation; arterial anastomosis, each Backbench reconstruction of cadaver or living donor renal allograft 50329 Prep renal graft/ureteral prior to transplantation; ureteral anastomosis, each 50340 Removal of kidney Recipient nephrectomy (separate procedure) Renal allotransplantation, implantation of graft; without recipient 50360 Transplantation of kidney nephrectomy Renal allotransplantation, implantation of graft; with recipient 50365 Transplantation of kidney nephrectomy 50370 Remove transplanted kidney Removal of transplanted renal allograft 50380 Reimplantation of kidney Renal autotransplantation, reimplantation of kidney Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, 50400 Revision of kidney/ureter pyelostomy, or ureteral splinting; simple Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney 50405 Revision of kidney/ureter abnormality, secondary pyeloplasty, solitary kidn 50500 Repair of kidney wound Nephrorrhaphy, suture of kidney wound or injury 50520 Close kidney-skin fistula Closure of nephrocutaneous or pyelocutaneous fistula Closure of nephrovisceral fistula (eg, renocolic), including visceral 50525 Repair renal-abdomen fistula repair; abdominal approach Closure of nephrovisceral fistula (eg, renocolic), including visceral 50526 Repair renal-abdomen fistula repair; thoracic approach Symphysiotomy for horseshoe kidney with or without pyeloplasty 50540 Revision of horseshoe kidney and/or other plastic procedure, unilateral or bilateral (one operation) Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph 50545 Laparo radical nephrectomy nodes, and adrenalectomy) 50546 Laparoscopic nephrectomy Laparoscopy, surgical; nephrectomy, including partial ureterectomy Page 3 of 5 Removed from IP Only list Laparoscopy, surgical; donor nephrectomy (including cold 50547 Laparo removal donor kidney preservation), from living donor 50548 Laparo remove w/ureter Laparoscopy, surgical; nephrectomy with total ureterectomy 50600 Exploration of ureter Ureterotomy with exploration or drainage (separate procedure) 50605 Insert ureteral support Ureterotomy for insertion of indwelling stent, all types 50610 Removal of ureter stone Ureterolithotomy; upper one-third of ureter 50620 Removal of ureter stone Ureterolithotomy; middle one-third of ureter 50630 Removal of ureter stone Ureterolithotomy; lower one-third of ureter 50650 Removal of ureter Ureterectomy, with bladder cuff (separate procedure) Ureterectomy, total, ectopic ureter, combination abdominal, vaginal 50660 Removal of ureter and/or perineal approach 50700 Revision of ureter Ureteroplasty, plastic operation on ureter (eg, stricture) Ureterolysis, with or without repositioning of ureter for retroperitoneal 50715 Release of ureter fibrosis 50722 Release of ureter Ureterolysis for ovarian vein syndrome Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary 50725 Release/revise ureter tract or vena cava Revision of urinary-cutaneous anastomosis (any type urostomy); with 50728 Revise ureter repair of fascial defect and hernia 50740 Fusion of ureter & kidney Ureteropyelostomy, anastomosis of ureter and renal pelvis 50750 Fusion of ureter & kidney Ureterocalycostomy, anastomosis of ureter to renal calyx 50760 Fusion of ureters Ureteroureterostomy Transureteroureterostomy, anastomosis of ureter to contralateral 50770 Splicing of ureters ureter 50780 Reimplant ureter in bladder Ureteroneocystostomy; anastomosis of single ureter to bladder 50782 Reimplant ureter in bladder Ureteroneocystostomy; anastomosis of duplicated ureter to bladder 50783 Reimplant ureter in bladder Ureteroneocystostomy; with extensive ureteral tailoring 50785 Reimplant ureter in bladder Ureteroneocystostomy; with vesico-psoas hitch or bladder flap 50800 Implant ureter in bowel Ureteroenterostomy, direct anastomosis of ureter to intestine Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine 50810 Fusion of ureter & bowel anastomosis 50815 Urine shunt to intestine Ureterocolon conduit, including intestine anastomosis Ureteroileal conduit (ileal bladder), including intestine anastomosis 50820 Construct bowel bladder (Bricker operation) Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey 50825 Construct bowel bladder enterocystoplasty) Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy 50830 Revise urine flow or ureteroneocystostomy) Page 4 of 5 Removed from IP Only list Replacement of all or part of ureter by intestine segment, including 50840 Replace ureter by bowel intestine anastomosis 50845 Appendico-vesicostomy Cutaneous appendico-vesicostomy 50860 Transplant ureter to skin Ureterostomy, transplantation of ureter to skin 50900 Repair of ureter Ureterorrhaphy, suture of ureter (separate procedure) 50920 Closure ureter/skin fistula Closure of ureterocutaneous fistula 50930 Closure ureter/bowel fistula Closure of ureterovisceral fistula (including visceral repair) 50940 Release of ureter Deligation of ureter Cystotomy; for excision of bladder diverticulum, single or multiple 51525 Removal of bladder lesion (separate procedure) 51530 Removal of bladder lesion Cystotomy; for excision of bladder tumor 51550 Partial removal of bladder Cystectomy, partial; simple Cystectomy, partial; complicated (eg, postradiation, previous surgery, 51555 Partial removal of bladder difficult location) Cystectomy, partial, with reimplantation of ureter(s) into bladder 51565 Revise bladder & ureter(s) (ureteroneocystostomy) 51570 Removal of bladder Cystectomy, complete; (separate procedure) Cystectomy, complete; with bilateral pelvic lymphadenectomy, 51575 Removal of bladder & nodes including external iliac, hypogastric, and obturator nodes Cystectomy, complete, with ureterosigmoidostomy or 51580 Remove bladder/revise tract ureterocutaneous transplantations; Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator 51585 Removal of bladder & nodes nodes Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, 51590 Remove bladder/revise tract including intestine anastomosis;

Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, 51595 Remove bladder/revise tract including external iliac, hypogastric, and obturator nodes Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct 51596 Remove bladder/create pouch neobladder Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum 51597 Removal of pelvic structures and colon and colostomy, or any combination there Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any 51800 Revision of bladder/urethra procedure, with or without wedge resection of posterior vesical neck 51820 Revision of urinary tract Cystourethroplasty with unilateral or bilateral ureteroneocystostomy Page 5 of 5 Removed from IP Only list Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti- 51840 Attach bladder/urethra Krantz, Burch); simple Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti- 51841 Attach bladder/urethra Krantz, Burch); complicated (eg, secondary repair)

51865 Repair of bladder wound Cystorrhaphy, suture of bladder wound, injury or rupture; complicated 51900 Repair bladder/vagina lesion Closure of vesicovaginal fistula, abdominal approach 51920 Close bladder-uterus fistula Closure of vesicouterine fistula; 51925 Hysterectomy/bladder repair Closure of vesicouterine fistula; with hysterectomy 51940 Correction of bladder defect Closure, exstrophy of bladder 51960 Revision of bladder & bowel Enterocystoplasty, including intestinal anastomosis 51980 Construct bladder opening Cutaneous vesicostomy Urethroplasty, transpubic or perineal, one stage, for reconstruction or 53415 Reconstruction of urethra repair of prostatic or membranous urethra Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of 53448 Remov/replc ur sphinctr comp infected tissue Page 1 of 1 Medicare IP Only List 2019 Maternity Care and Delivery CPT/ HCPCS Short Description Long Description Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections), including hospital 59850 Abortion admission and visits, delivery of fetus and secundines;

Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections), including hospital 59851 Abortion admission and visits, delivery of fetus and secundines; with dilation and curettage and/or evacuation

Induced abortion, by one or more intra-amniotic injections (amniocentesis-injections), including hospital 59852 Abortion admission and visits, delivery of fetus and secundines; with hysterotomy (failed intra-amniotic injection) Induced abortion, by one or more vaginal suppositories (eg, prostaglandin) with or without cervical 59855 Abortion dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; Induced abortion, by one or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with 59856 Abortion dilation and curettage and/or evacuation Induced abortion, by one or more vaginal suppositories (eg, prostaglandin) with or without cervical dilation (eg, laminaria), including hospital admission and visits, delivery of fetus and secundines; with 59857 Abortion hysterotomy (failed medical evacuation) 59620 Attempted vbac delivery only Cesarean delivery only, following attempted vaginal delivery after previous cesarean delivery; 59514 Cesarean delivery only Cesarean delivery only; Remove uterus after Subtotal or total hysterectomy after cesarean delivery (List separately in addition to code for primary 59525 cesarean procedure) 59350 Repair of uterus Hysterorrhaphy of ruptured uterus 59325 Revision of cervix Cerclage of cervix, during pregnancy; abdominal Surgical treatment of ectopic pregnancy; tubal or ovarian, requiring salpingectomy and/or 59120 Treat ectopic pregnancy oophorectomy, abdominal or vaginal approach

59121 Treat ectopic pregnancy Surgical treatment of ectopic pregnancy; tubal or ovarian, without salpingectomy and/or oophorectomy 59130 Treat ectopic pregnancy Surgical treatment of ectopic pregnancy; abdominal pregnancy 59135 Treat ectopic pregnancy Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy requiring total hysterectomy 59136 Treat ectopic pregnancy Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus 59140 Treat ectopic pregnancy Surgical treatment of ectopic pregnancy; cervical, with evacuation 59830 Treat uterus infection Treatment of septic abortion, completed surgically Page 1 of 12 Medicare IP Only List 2019 Musculoskeletal System CPT/ HCPCS Short Description Long Description Removed from IP Only List 20661 Application of head brace Application of halo, including removal; cranial Application of halo, including removal, cranial, 6 or more pins placed, for thin skull osteology (eg, pediatric patients, hydrocephalus, osteogenesis imperfecta), requiring general 20664 Application of halo anesthesia Replantation, arm (includes surgical neck of humerus through 20802 Replantation arm complete elbow joint), complete amputation Replantation, forearm (includes radius and ulna to radial carpal 20805 Replant forearm complete joint), complete amputation Replantation, hand (includes hand through metacarpophalangeal 20808 Replantation hand complete joints), complete amputation Replantation, digit, excluding thumb (includes metacarpophalangeal joint to insertion of flexor sublimis tendon), 20816 Replantation digit complete complete amputation Replantation, thumb (includes carpometacarpal joint to MP joint), 20824 Replantation thumb complete complete amputation Replantation, thumb (includes distal tip to MP joint), complete 20827 Replantation thumb complete amputation 20838 Replantation foot complete Replantation, foot, complete amputation 20955 Fibula bone graft microvasc Bone graft with microvascular anastomosis; fibula 20956 Iliac bone graft microvasc Bone graft with microvascular anastomosis; iliac crest 20957 Mt bone graft microvasc Bone graft with microvascular anastomosis; metatarsal Bone graft with microvascular anastomosis; other than fibula, iliac 20962 Other bone graft microvasc crest, or metatarsal Free osteocutaneous flap with microvascular anastomosis; other 20969 Bone/skin graft microvasc than iliac crest, metatarsal, or great toe Free osteocutaneous flap with microvascular anastomosis; iliac 20970 Bone/skin graft iliac crest crest 21045 Extensive jaw surgery Excision of malignant tumor of mandible; radical resection Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without 21141 Lefort i-1 piece w/o graft bone graft Reconstruction midface, LeFort I; two pieces, segment movement 21142 Lefort i-2 piece w/o graft in any direction, without bone graft Reconstruction midface, LeFort I; three or more pieces, segment 21143 Lefort i-3/> piece w/o graft movement in any direction, without bone graft Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes 21145 Lefort i-1 piece w/ graft obtaining autografts) Reconstruction midface, LeFort I; two pieces, segment movement in any direction, requiring bone grafts (includes obtaining 21146 Lefort i-2 piece w/ graft autografts) (eg, ungrafted unilateral alveolar cleft) Reconstruction midface, LeFort I; three or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or 21147 Lefort i-3/> piece w/ graft multiple osteotomies) Reconstruction midface, LeFort II; any direction, requiring bone 21151 Lefort ii w/bone grafts grafts (includes obtaining autografts) Page 2 of 12

Removed from IP Only List Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without 21154 Lefort iii w/o lefort i LeFort I

Reconstruction midface, LeFort III (extracranial), any type, 21155 Lefort iii w/ lefort i requiring bone grafts (includes obtaining autografts); with LeFort I Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts 21159 Lefort iii w/fhdw/o lefort i (includes obtaining autografts); without LeFort I Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts 21160 Lefort iii w/fhd w/ lefort i (includes obtaining autografts); with LeFort I Reconstruction, entire or majority of forehead and/or supraorbital 21179 Reconstruct entire forehead rims; with grafts (allograft or prosthetic material) Reconstruction, entire or majority of forehead and/or supraorbital 21180 Reconstruct entire forehead rims; with autograft (includes obtaining grafts)

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts 21182 Reconstruct cranial bone (includes obtaining grafts); total area of bone grafting less

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts 21183 Reconstruct cranial hone (includes obtaining grafts); total area of bone grafting grea

Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts 21184 Reconstruct cranial bone (includes obtaining grafts); total area of bone grafting grea Reconstruction midface, osteotomies (other than LeFort type) and 21188 Reconstruction of midface bone grafts (includes obtaining autografts) Reconstruction of mandibular rami, horizontal, vertical, C, or L 21194 Reconst lwr jaw w/graft osteotomy; with bone graft (includes obtaining graft) Reconstruction of mandibular rami and/or body, sagittal split; with 21196 Reconst lwr jaw w/fixation internal rigid fixation Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial 21247 Reconstruct lower jaw bone microsomia) Reconstruction of zygomatic arch and glenoid fossa with bone 21255 Reconstruct lower jaw bone and cartilage (includes obtaining autografts) Orbital repositioning, periorbital osteotomies, unilateral, with bone 21268 Revise eye sockets grafts; combined intra- and extracranial approach 21343 Open tx dprsd front sinus fx Open treatment of depressed frontal sinus fracture Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple 21344 Open tx compl front sinus fx approaches Open treatment of nasomaxillary complex fracture (LeFort II 21347 Opn tx nasomax fx multple type); requiring multiple open approaches Open treatment of nasomaxillary complex fracture (LeFort II 21348 Opn tx nasomax fx w/graft type); with bone grafting (includes obtaining graft) Page 3 of 12

Removed from IP Only List Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes 21366 Opn tx complx malar w/grft obtaining graft) 21422 Treat mouth roof fracture Open treatment of palatal or maxillary fracture (LeFort I type); Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), 21423 Treat mouth roof fracture multiple approaches Closed treatment of craniofacial separation (LeFort III type) using 21431 Treat craniofacial fracture interdental wire fixation of denture or splint Open treatment of craniofacial separation (LeFort III type); with 21432 Treat craniofacial fracture wiring and/or internal fixation Open treatment of craniofacial separation (LeFort III type); complicated (eg, comminuted or involving cranial nerve foramina), 21433 Treat craniofacial fracture multiple surgical approaches Open treatment of craniofacial separation (LeFort III type); complicated, utilizing internal and/or external fixation techniques 21435 Treat craniofacial fracture (eg, head cap, halo device, and/or intermaxillary fixation) Open treatment of craniofacial separation (LeFort III type); complicated, multiple surgical approaches, internal fixation, with 21436 Treat craniofacial fracture bone grafting (includes obtaining graft) Incision, deep, with opening of bone cortex (eg, for osteomyelitis 21510 Drainage of bone lesion or bone abscess), thorax 21615 Removal of rib Excision first and/or cervical rib; 21616 Removal of rib and nerves Excision first and/or cervical rib; with sympathectomy 21620 Partial removal of sternum Ostectomy of sternum, partial 21627 Sternal debridement Sternal debridement 21630 Extensive sternum surgery Radical resection of sternum;

21632 Extensive sternum surgery Radical resection of sternum; with mediastinal lymphadenectomy 21705 Revision of neck muscle/rib Division of scalenus anticus; with resection of cervical rib 21740 Reconstruction of sternum Reconstructive repair of pectus excavatum or carinatum; open Closure of median sternotomy separation with or without 21750 Repair of sternum separation debridement (separate procedure) Open treatment of sternum fracture with or without skeletal 21825 Treat sternum fracture fixation Incision and drainage, open, of deep abscess (subfascial), 22010 I&d p-spine c/t/cerv-thor posterior spine; cervical, thoracic, or cervicothoracic Incision and drainage, open, of deep abscess (subfascial), 22015 I&d p-spine I/s/ls posterior spine; lumbar, sacral, or lumbosacral Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral 22110 Remove part of neck vertebra segment; cervical Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral 22112 Remove part thorax vertebra segment; thoracic Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral 22114 Remove part lumbar vertebra segment; lumbar Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; each additional vertebral segment (List separately in 22116 Remove extra spine segment addition to code for primary procedure) Page 4 of 12

Removed from IP Only List

OSTEOTOMY OF SPINE, POSTERIOR OR POSTEROLATERAL APPROACH, 3 COLUMNS, 1 VERTEBRAL SEGMENT (EG, 22206 Incis spine 3 column thorac PEDICLE/VERTEBRAL BODY SUBTRACTION); THORACIC Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body 22207 Incis spine 3 column lumbar subtraction); lumbar Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); each additional vertebral segment (list separately in 22208 Incis spine 3 column adl seg addition to code for primary procedure) Osteotomy of spine, posterior or posterolateral approach, one 22210 Incis 1 vertebral seg cerv vertebral segment; cervical Osteotomy of spine, posterior or posterolateral approach, one 22212 Incis 1 vertebral seg thorac vertebral segment; thoracic Osteotomy of spine, posterior or posterolateral approach, one 22214 Incis 1 vertebral seg lumbar vertebral segment; lumbar Osteotomy of spine, posterior or posterolateral approach, one vertebral segment; each additional vertebral segment (List 22216 Revise extra spine segment separately in addition to primary procedure) Osteotomy of spine, including discectomy, anterior approach, 22220 Incis w/discectomy cervical single vertebral segment; cervical Osteotomy of spine, including discectomy, anterior approach, 22222 Incis w/discectomy thoracic single vertebral segment; thoracic Osteotomy of spine, including discectomy, anterior approach, 22224 Incis w/discectomy lumbar single vertebral segment; lumbar Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; each additional vertebral segment (List 22226 Revise extra spine segment separately in addition to code for primary procedure) Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, 22318 Treat odontoid fx w/o graft including placement of internal fixation; without grafting Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, 22319 Treat odontoid fx w/graft including placement of internal fixation; with grafting Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, one fractured vertebrae or 22325 Treat spine fracture dislocated segment; lumbar Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, one fractured vertebrae or 22326 Treat neck spine fracture dislocated segment; cervical Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, one fractured vertebrae or 22327 Treat thorax spine fracture dislocated segment; thoracic Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, one fractured vertebrae or dislocated segment; each additional fractured vertebrae or dislocated segment (List separately in addition to code for primary 22328 Treat each add spine fx p Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); 22532 Lat thorax spine fusion thoracic Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); 22533 Lat lumbar spine fusion lumbar Page 5 of 12

Removed from IP Only List

Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracic or lumbar, each additional vertebral segment (List 22534 Lat thor/lumb addl seg separately in addition to code for primary procedure) Arthrodesis, anterior transoral or extraoral technique, clivus-C1- 22548 Neck spine fusion C2 (atlas-axis), with or without excision of odontoid process Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); 22556 Thorax spine fusion thoracic Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); 22558 Lumbar spine fusion lumbar Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 22586 Prescrl fuse w/ instr l5/s1 interspace 22590 Spine & skull spinal fusion Arthrodesis, posterior technique, craniocervical (occiput-C2) 22595 Neck spinal fusion Arthrodesis, posterior technique, atlas-axis (C1-C2) Arthrodesis, posterior or posterolateral technique, single level; 22600 Neck spine fusion cervical below C2 segment Arthrodesis, posterior or posterolateral technique, single level; 22610 Thorax spine fusion thoracic (with or without lateral transverse technique) Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for 22630 Lumbar spine fusion decompression), single interspace; lumbar

Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace; each additional interspace 22632 Spine fusion extra segment (List separately in addition to code for primary procedure) Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for 22633 Lumbar spine fusion combined decompression), single interspace and segment; lumbar Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace and segment; each additional interspace and segment (list separately in addition to code for 22634 Spine fusion extra segment primary procedure) Arthrodesis, posterior, for spinal deformity, with or without cast; 22800 Fusion of spine up to 6 vertebral segments Arthrodesis, posterior, for spinal deformity, with or without cast; 7 22802 Fusion of spine to 12 vertebral segments Arthrodesis, posterior, for spinal deformity, with or without cast; 22804 Fusion of spine 13 or more vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 2 22808 Fusion of spine to 3 vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 4 22810 Fusion of spine to 7 vertebral segments Arthrodesis, anterior, for spinal deformity, with or without cast; 8 22812 Fusion of spine or more vertebral segments Page 6 of 12

Removed from IP Only List Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 22818 Kyphectomy 1-2 segments single or 2 segments Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 22819 Kyphectomy 3 or more or more segments 22830 Exploration of spinal fusion Exploration of spinal fusion 22841 Insert spine fixation device Internal spinal fixation by wiring of spinous processes Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 7 to 12 vertebral 22843 Insert spine fixation device segments Posterior segmental instrumentation (eg, pedicle fixation, dual rods with multiple hooks and sublaminar wires); 13 or more 22844 Insert spine fixation device vertebral segments 22846 Insert spine fixation device Anterior instrumentation; 4 to 7 vertebral segments 22847 Insert spine fixation device Anterior instrumentation; 8 or more vertebral segments Pelvic fixation (attachment of caudal end of instrumentation to 22848 Insert pelv fixation device pelvic bony structures) other than sacrum 22849 Reinsert spinal fixation Reinsertion of spinal fixation device Removal of posterior nonsegmental instrumentation (eg, 22850 Remove spine fixation device Harrington rod) 22852 Remove spine fixation device Removal of posterior segmental instrumentation 22855 Remove spine fixation device Removal of anterior instrumentation Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), 22857 Lumbar artif diskectomy lumbar, single interspace Revision including replacement of total disc arthroplasty (artificial 22861 Revise cerv artific disc disc), anterior approach, single interspace; cervical Revision including replacement of total disc arthroplasty (artificial 22862 Revise lumbar artif disc disc) anterior approach, lumbar, single interspace Removal of total disc arthroplasty (artificial disc), anterior 22864 Remove cerv artif disc approach, single interspace; cervical Removal of total disc arthroplasty (artificial disc), anterior 22865 Remove lumb artif disc approach, lumbar, single interspace 23200 Resect clavicle tumor Radical resection for tumor; clavicle 23210 Resect scapula tumor Radical resection for tumor; scapula 23220 Resect prox humerus tumor Radical resection of bone tumor, proximal humerus; Removal of prosthesis, includes debridement and synovectomy when performed; humeral and glenoid components (eg, total 23335 Shoulder prosthesis removal shoulder) Arthroplasty, glenohumeral joint; total shoulder (glenoid and 23472 Reconstruct shoulder joint proximal humeral replacement (eg, total shoulder)) Revision of total shoulder arthroplasty, including allograft when 23474 Revis reconst shoulder joint performed; humeral and glenoid component 23900 Ampatation of arm & girdle Interthoracoscapular amputation (forequarter) 23920 Amputation at shoulder joint Disarticulation of shoulder; 24900 Amputation of upper arm Amputation, arm through humerus; with primary closure 24920 Amputation of upper arm Amputation, arm through humerus; open, circular (guillotine) 24930 Amputation follow-up surgery Amputation, arm through humerus; re-amputation 24931 Amputate upper arm & implant Amputation, arm through humerus; with implant 24940 Revision of upper arm Cineplasty, upper extremity, complete procedure 25900 Amputation of forearm Amputation, forearm, through radius and ulna; Amputation, forearm, through radius and ulna; open, circular 25905 Amputation of forearm (guillotine) 25915 Amputation of forearm Krukenberg procedure Page 7 of 12

Removed from IP Only List 25920 Amputate hand at wrist Disarticulation through wrist; 25924 Amputation follow-up surgery Disarticulation through wrist; re-amputation 25927 Amputation of hand Transmetacarpal amputation; Transfer, toe-to-hand with microvascular anastomosis; great toe 26551 Great toe-hand transfer wrap-around with bone graft Transfer, toe-to-hand with microvascular anastomosis; other than 26553 Single transfer toe-hand great toe, single Transfer, toe-to-hand with microvascular anastomosis; other than 26554 Doable transfer toe-hand great toe, double 26556 Toe joint transfer Transfer, free toe joint, with microvascular anastomosis Incision, bone cortex, pelvis and/or hip joint (eg, osteomyelitis or 26992 Drainage of bone lesion bone abscess) 27005 Incision of hip tendon Tenotomy, hip flexor(s), open (separate procedure) 27025 Incision of hip/thigh fascia Fasciotomy, hip or thigh, any type 27030 Drainage of hip joint Arthrotomy, hip, with drainage (eg, infection) Capsulectomy or capsulotomy, hip, with or without excision of heterotopic bone, with release of hip flexor muscles (ie, gluteus medius, gluteus minimus, tensor fascia latae, rectus femoris, 27036 Excision of hip joint/muscle sartorius, iliopsoas) 27054 Removal of hip joint lining Arthrotomy with synovectomy, hip joint Partial excision (craterization, saucerization) (eg, osteomyelitis or bone abscess); superficial (eg, wing of ilium, symphysis pubis, or 27070 Part remove hip bone super greater trochanter of femur) Partial excision (craterization, saucerization) (eg, osteomyelitis or 27071 Part removal hip bone deep bone abscess); deep (subfascial or intramuscular) Radical resection of tumor or infection; wing of ilium, one pubic or 27075 Resect hip tumor ischial ramus or symphysis pubis Radical resection of tumor or infection; ilium, including 27076 Resect hip tum incl acetabul acetabulum, both pubic rami, or ischium and acetabulum 27077 Resect hip turn w/innom bone Radical resection of tumor or infection; innominate bone, total Radical resection of tumor or infection; ischial tuberosity and 27078 Rsect hip tum incl femur greater trochanter of femur 27090 Removal of hip prosthesis Removal of hip prosthesis; (separate procedure)

Removal of hip prosthesis; complicated, including total hip 27091 Removal of hip prosthesis prosthesis, methylmethacrylate with or without insertion of spacer

27120 Reconstruction of hip socket Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type) Acetabuloplasty; resection, femoral head (eg, Girdlestone 27122 Reconstruction of hip socket procedure) Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar 27125 Partial hip replacement arthroplasty) Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or 27130 Total hip arthroplasty allograft Conversion of previous hip surgery to total hip arthroplasty, with 27132 Total hip arthroplasty or without autograft or allograft Revision of total hip arthroplasty; both components, with or 27134 Revise hip joint replacement without autograft or allograft Revision of total hip arthroplasty; acetabular component only, with 27137 Revise hip joint replacement or without autograft or allograft Revision of total hip arthroplasty; femoral component only, with or 27138 Revise hip joint replacement without allograft Osteotomy and transfer of greater trochanter of femur (separate 27140 Transplant femur ridge procedure) Page 8 of 12

Removed from IP Only List 27146 Incision of hip bone Osteotomy, iliac, acetabular or innominate bone; Osteotomy, iliac, acetabular or innominate bone; with open 27147 Revision of hip bone reduction of hip Osteotomy, iliac, acetabular or innominate bone; with femoral 27151 Incision of hip bones osteotomy Osteotomy, iliac, acetabular or innominate bone; with femoral 27156 Revision of hip bones osteotomy and with open reduction of hip 27158 Revision of pelvis Osteotomy, pelvis, bilateral (eg, congenital malformation) 27161 Incision of neck of femur Osteotomy, femoral neck (separate procedure) Osteotomy, intertrochanteric or subtrochanteric including internal 27165 Incision/fixation of femur or external fixation and/or cast Bone graft, femoral head, neck, intertrochanteric or 27170 Repair/graft femur head/neck subtrochanteric area (includes obtaining bone graft) Treatment of slipped femoral epiphysis; by traction, without 27175 Treat slipped epiphysis reduction Treatment of slipped femoral epiphysis; by single or multiple 27176 Treat slipped epiphysis pinning, in situ Open treatment of slipped femoral epiphysis; single or multiple 27177 Treat slipped epiphysis pinning or bone graft (includes obtaining graft) Open treatment of slipped femoral epiphysis; closed manipulation 27178 Treat slipped epiphysis with single or multiple pinning Open treatment of slipped femoral epiphysis; osteotomy and 27181 Treat slipped epiphysis internal fixation Epiphyseal arrest by epiphysiodesis or stapling, greater 27185 Revision of femur epiphysis trochanter of femur Prophylactic treatment (nailing, pinning, plating or wiring) with or 27187 Reinforce hip bones without methylmethacrylate, femoral neck and proximal femur Closed treatment of acetabulum (hip socket) fracture(s); with 27222 Treat hip socket fracture manipulation, with or without skeletal traction Open treatment of posterior or anterior acetabular wall fracture, 27226 Treat hip wall fracture with internal fixation Open treatment of acetabular fracture(s) involving anterior or posterior (one) column, or a fracture running transversely across 27227 Treat hip fracture(s) the acetabulum, with internal fixation Open treatment of acetabular fracture(s) involving anterior and posterior (two) columns, includes T-fracture and both column fracture with complete articular detachment, or single column or 27228 Treat hip fracture(s) transverse fracture with associated acetabular wall fracture, wit Closed treatment of femoral fracture, proximal end, neck; with 27232 Treat thigh fracture manipulation, with or without skeletal traction Open treatment of femoral fracture, proximal end, neck, internal 27236 Treat thigh fracture fixation or prosthetic replacement Closed treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with manipulation, with or 27240 Treat thigh fracture without skin or skeletal traction Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with plate/screw type implant, with or without 27244 Treat thigh fracture cerclage Treatment of intertrochanteric, peritrochanteric, or subtrochanteric femoral fracture; with intramedullary implant, with or without 27245 Treat thigh fracture interlocking screws and/or cerclage Open treatment of greater trochanteric fracture, with or without 27248 Treat thigh fracture internal or external fixation Open treatment of hip dislocation, traumatic, without internal 27253 Treat hip dislocation fixation Page 9 of 12

Removed from IP Only List Open treatment of hip dislocation, traumatic, with acetabular wall and femoral head fracture, with or without internal or external 27254 Treat hip dislocation fixation Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head 27258 Treat hip dislocation in acetabulum (including tenotomy, etc); Open treatment of spontaneous hip dislocation (developmental, including congenital or pathological), replacement of femoral head in acetabulum (including tenotomy, etc); with femoral shaft 27259 Treat hip dislocation shortening Closed treatment of femoral fracture, proximal end, head; with 27268 Cltx thigh fx w/mnpj manipulation Open treatment of femoral fracture, proximal end, head, includes 27269 Optx thigh fx internal fixation, when performed 27280 Fusion of sacroiliac joint Arthrodesis, sacroiliac joint (including obtaining graft) 27282 Fusion of pubic bones Arthrodesis, symphysis pubis (including obtaining graft) 27284 Fusion of hip joint Arthrodesis, hip joint (including obtaining graft); Arthrodesis, hip joint (including obtaining graft); with 27286 Fusion of hip joint subtrochanteric osteotomy 27290 Amputation of leg at hip Interpelviabdominal amputation (hindquarter amputation) 27295 Amputation of leg at hip Disarticulation of hip Incision, deep, with opening of bone cortex, femur or knee (eg, 27303 Drainage of bone lesion osteomyelitis or bone abscess) 27365 Resect femur/knee tumor Radical resection of tumor, bone, femur or knee 27445 Revision of knee joint Arthroplasty, knee, hinge prosthesis (eg, Walldius type) 27448 Incision of thigh Osteotomy, femur, shaft or supracondylar; without fixation 27450 Incision of thigh Osteotomy, femur, shaft or supracondylar; with fixation Osteotomy, multiple, with realignment on intramedullary rod, 27454 Realignment of thigh bone femoral shaft (eg, Sofield type procedure) Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus (bowleg) or genu valgus 27455 Realignment of knee (knock-knee)); before epiphyseal closure Osteotomy, proximal tibia, including fibular excision or osteotomy (includes correction of genu varus (bowleg) or genu valgus 27457 Realignment of knee (knock-knee)); after epiphyseal closure 27465 Shortening of thigh bone Osteoplasty, femur; shortening (excluding 64876) 27466 Lengthening of thigh bone Osteoplasty, femur; lengthening Osteoplasty, femur; combined, lengthening and shortening with 27468 Shorten/lengthen thighs femoral segment transfer Repair, nonunion or malunion, femur, distal to head and neck; 27470 Repair of thigh without graft (eg, compression technique)

Repair, nonunion or malunion, femur, distal to head and neck; 27472 Repair/graft of thigh with iliac or other autogenous bone graft (includes obtaining graft) Revision of total knee arthroplasty, with or without allograft; one 27486 Revise/replace knee joint component Revision of total knee arthroplasty, with or without allograft; 27487 Revise/replace knee joint femoral and entire tibial component Removal of prosthesis, including total knee prosthesis, 27488 Removal of knee prosthesis methylmethacrylate with or without insertion of spacer, knee Prophylactic treatment (nailing, pinning, plating or wiring) with or 27495 Reinforce thigh without methylmethacrylate, femur Open treatment of femoral shaft fracture, with or without external fixation, with insertion of intramedullary implant, with or without 27506 Treatment of thigh fracture cerclage and/or locking screws Page 10 of 12

Removed from IP Only List Open treatment of femoral shaft fracture with plate/screws, with 27507 Treatment of thigh fracture or without cerclage Open treatment of femoral supracondylar or transcondylar fracture without intercondylar extension, with or without internal or 27511 Treatment of thigh fracture external fixation Open treatment of femoral supracondylar or transcondylar fracture with intercondylar extension, with or without internal or 27513 Treatment of thigh fracture external fixation Open treatment of femoral fracture, distal end, medial or lateral 27514 Treatment of thigh fracture condyle, with or without internal or external fixation Open treatment of distal femoral epiphyseal separation, with or 27519 Treat thigh fx growth plate without internal or external fixation Open treatment of tibial fracture, proximal (plateau); unicondylar, 27535 Treat knee fracture with or without internal or external fixation Open treatment of tibial fracture, proximal (plateau); bicondylar, 27536 Treat knee fracture with or without internal fixation

Open treatment of intercondylar spine(s) and/or tuberosity 27540 Treat knee fracture fracture(s) of the knee, with or without internal or external fixation Open treatment of knee dislocation, with or without internal or external fixation; without primary ligamentous repair or 27556 Treat knee dislocation augmentation/reconstruction Open treatment of knee dislocation, with or without internal or 27557 Treat knee dislocation external fixation; with primary ligamentous repair Open treatment of knee dislocation, with or without internal or external fixation; with primary ligamentous repair, with 27558 Treat knee dislocation augmentation/reconstruction 27580 Fusion of knee Arthrodesis, knee, any technique 27590 Amputate leg at thigh Amputation, thigh, through femur, any level; Amputation, thigh, through femur, any level; immediate fitting 27591 Amputate leg at thigh technique including first cast Amputation, thigh, through femur, any level; open, circular 27592 Amputate leg at thigh (guillotine) 27596 Amputation follow-up surgery Amputation, thigh, through femur, any level; re-amputation 27598 Amputate lower leg at knee Disarticulation at knee 27645 Resect tibia tumor Radical resection of tumor, bone; tibia 27646 Resect fibula tumor Radical resection of tumor, bone; fibula 27702 Reconstruct ankle joint Arthroplasty, ankle; with implant (total ankle) 27703 Reconstruction ankle joint Arthroplasty, ankle; revision, total ankle Osteotomy; multiple, with realignment on intramedullary rod (eg, 27712 Realignment of lower leg Sofield type procedure) 27715 Revision of lower leg Osteoplasty, tibia and fibula, lengthening or shortening Repair of nonunion or malunion, tibia; with iliac or other autograft 27724 Repair/graft of tibia (includes obtaining graft) Repair of nonunion or malunion, tibia; by synostosis, with fibula, 27725 Repair of lower leg any method 27727 Repair of lower leg Repair of congenital pseudarthrosis, tibia 27880 Amputation of lower leg Amputation, leg, through tibia and fibula; Amputation, leg, through tibia and fibula; with immediate fitting 27881 Amputation of lower leg technique including application of first cast

27882 Amputation of lower leg Amputation, leg, through tibia and fibula; open, circular (guillotine) 27886 Amputation follow-up surgery Amputation, leg, through tibia and fibula; re-amputation Page 11 of 12

Removed from IP Only List Amputation, ankle, through malleoli of tibia and fibula (eg, Syme, Pirogoff type procedures), with plastic closure and resection of 27888 Amputation of foot at ankle nerves 28800 Amputation of midfoot Amputation, foot; midtarsal (eg, Chopart type procedure) Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), each additional interspace, cervical (list separately in addition to code for primary procedure) 0092T Artific disc addl cervical Removal of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list separately in 0095T Rmvl artific disc addl crvcl addition to code for primary procedure)

Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, cervical (list 0098T Rev artific disc addl separately in addition to code for primary procedure) Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to 0163T Lumb artif diskectomy addl code for primary procedure) Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), each additional interspace, lumbar (list separately in addition to 0164T Remove lumb artif disc addl code for primary procedure) Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, each additional interspace, lumbar (list 0165T Revise lumb artif disc addl separately in addition to code for primary procedure) Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image 0195T Prescrl fuse w/o instr l5/s1 guidance, includes bone graft when performed; l5-s1 interspace Arthrodesis, pre-sacral interbody technique, disc space preparation, discectomy, without instrumentation, with image guidance, includes bone graft when performed; l4-l5 interspace 0196T Prescrl fuse w/o instr l4/l5 (list separately in addition to code for primary procedure)

Posterior vertebral joint(s) arthroplasty (eg, facet joint[s] replacement), including facetectomy, laminectomy, foraminotomy, and vertebral column fixation, injection of bone cement, when 0202T Post vert arthrplst 1 lumbar performed, including fluoroscopy, single level, lumbar spine Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or synthetic device(s), single level; cervical 0219T Plmt post facet implt cerv Placement of a posterior intrafacet implant(s), unilateral or bilateral, including imaging and placement of bone graft(s) or 0220T Plmt post facet implt thor synthetic device(s), single level; thoracic Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4- L5 interspace (List separately in addition to code for primary 0309T Prescrl fuse w/ instr l4/l5 procedure) Page 12 of 12

Removed from IP Only List Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft, when performed, lumbar, L4- L5 interspace (List separately in addition to code for primary 0309T Prescrl fuse w/ instr l4/l5 procedure) 0375T Total disc arthrp ant appr Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection), cervical, three or more levels Open treatment of iliac spine(s), 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 G0412 Open tx iliac spine uni/bil performed Open treatment of anterior pelvic bone fracture and/or dislocation for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation when performed (includes pubic G0414 Pelvic ring fx treat int fix symphysis and/or superior/inferior rami) Open treatment of posterior pelvic bone fracture and/or dislocation, for fracture patterns which disrupt the pelvic ring, unilateral or bilateral, includes internal fixation, when performed G0415 Open tx post pelvic fxcture (includes ilium, sacroiliac joint and/or sacrum) Page 1 of 10 Medicare IP Only List 2019 Nervous System CPT/ HCPCS Short Description Long Description Removed from IP Only List Added to IP Only List 61105 Twist drill hole Twist drill hole for subdural or ventricular puncture Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for implanting ventricular catheter, pressure recording device, or other 61107 Drill skull for implantation intracerebral monitoring device Twist drill hole(s) for subdural, intracerebral, or ventricular puncture; for 61108 Drill skull for drainage evacuation and/or drainage of subdural hematoma Burr hole(s) for ventricular puncture (including injection of gas, contrast media, 61120 Burr hole for puncture dye, or radioactive material) 61140 Pierce skull for biopsy Burr hole(s) or trephine; with biopsy of brain or intracranial lesion 61150 Pierce skull for drainage Burr hole(s) or trephine; with drainage of brain abscess or cyst Burr hole(s) or trephine; with subsequent tapping (aspiration) of intracranial 61151 Pierce skull for drainage abscess or cyst Burr hole(s) with evacuation and/or drainage of hematoma, extradural or 61154 Pierce skull & remove clot subdural 61156 Pierce skull for drainage Burr hole(s); with aspiration of hematoma or cyst, intracerebral Burr hole(s); for implanting ventricular catheter, reservoir, EEG electrode(s), pressure recording device, or other cerebral monitoring device (separate 61210 Pierce skull implant device procedure) Burr hole(s) or trephine, supratentorial, exploratory, not followed by other 61250 Pierce skull & explore surgery 61253 Pierce skull & explore Burr hole(s) or trephine, infratentorial, unilateral or bilateral 61304 Open skull for exploration Craniectomy or craniotomy, exploratory; supratentorial 61305 Open skull for exploration Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) Craniectomy or craniotomy for evacuation of hematoma, supratentorial; 61312 Open skull for drainage extradural or subdural Craniectomy or craniotomy for evacuation of hematoma, supratentorial; 61313 Open skull for drainage intracerebral Craniectomy or craniotomy for evacuation of hematoma, infratentorial; 61314 Open skull for drainage extradural or subdural Craniectomy or craniotomy for evacuation of hematoma, infratentorial; 61315 Open skull for drainage intracerebellar Incision and subcutaneous placement of cranial bone graft (List separately in 61316 Implt cran bone flap to abdo addition to code for primary procedure)

61320 Open skull for drainage Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial 61321 Open skull for drainage Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated 61322 Decompressive craniotomy intraparenchymal hematoma; without lobectomy Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated 61323 Decompressive lobectomy intraparenchymal hematoma; with lobectomy 61332 Explore/biopsy eye socket Exploration of orbit (transcranial approach); with biopsy 61333 Explore orbit/remove lesion Exploration of orbit (transcranial approach); with removal of lesion Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle 61340 Subtemporal decompression syndrome) Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari 61343 Incise skull (press relief) malformation) 61345 Relieve cranial pressure Other cranial decompression, posterior fossa Craniectomy, subtemporal, for section, compression, or decompression of 61450 Incise skull for surgery sensory root of gasserian ganglion Page 2 of 10 Added to IP Only List

61458 Incise skull for brain wound Craniectomy, suboccipital; for exploration or decompression of cranial nerves 61460 Incise skull for surgery Craniectomy, suboccipital; for section of one or more cranial nerves 61480 Incise skull for surgery Craniectomy, suboccipital; for mesencephalic tractotomy or pedunculotomy 61490 Incise skull for surgery Craniotomy for lobotomy, including cingulotomy 61500 Removal of skull lesion Craniectomy; with excision of tumor or other bone lesion of skull 61501 Remove infected skull bone Craniectomy; for osteomyelitis Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, 61510 Removal of brain lesion supratentorial, except meningioma Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, 61512 Remove brain lining lesion supratentorial Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, 61514 Removal of brain abscess supratentorial Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of 61516 Removal of brain lesion cyst, supratentorial Implantation of brain intracavitary chemotherapy agent (List separately in 61517 Implt brain chemotx add-on addition to code for primary procedure) Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of 61518 Removal of brain lesion skull Craniectomy for excision of brain tumor, infratentorial or posterior fossa; 61519 Remove brain lining lesion meningioma Craniectomy for excision of brain tumor, infratentorial or posterior fossa; 61520 Removal of brain lesion cerebellopontine angle tumor Craniectomy for excision of brain tumor, infratentorial or posterior fossa; 61521 Removal of brain lesion midline tumor at base of skull 61522 Removal of brain abscess Craniectomy, infratentorial or posterior fossa; for excision of brain abscess Craniectomy, infratentorial or posterior fossa; for excision or fenestration of 61524 Removal of brain lesion cyst Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of 61526 Removal of brain lesion cerebellopontine angle tumor; Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa 61530 Removal of brain lesion craniotomy/craniectomy Subdural implantation of strip electrodes through one or more burr or trephine 61531 Implant brain electrodes hole(s) for long term seizure monitoring Craniotomy with elevation of bone flap; for subdural implantation of an 61533 Implant brain electrodes electrode array, for long term seizure monitoring Craniotomy with elevation of bone flap; for excision of epileptogenic focus 61534 Removal of brain lesion without electrocorticography during surgery Craniotomy with elevation of bone flap; for removal of epidural or subdural 61535 Remove brain electrodes electrode array, without excision of cerebral tissue (separate procedure) Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode 61536 Removal of brain lesion array) Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without 61537 Removal of brain tissue electrocorticography during surgery Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with 61538 Removal of brain tissue electrocorticography during surgery Craniotomy with elevation of bone flap; for lobectomy, other than temporal 61539 Removal of brain tissue lobe, partial or total, with electrocorticography during surgery Craniotomy with elevation of bone flap; for lobectomy, other than temporal 61540 Removal of brain tissue lobe, partial or total, without electrocorticography during surgery 61541 Incision of brain tissue Craniotomy with elevation of bone flap; for transection of corpus callosum 61542 Removal of brain tissue Craniotomy with elevation of bone flap; for total hemispherectomy Craniotomy with elevation of bone flap; for partial or subtotal (functional) 61543 Removal of brain tissue hemispherectomy Page 3 of 10 Added to IP Only List Craniotomy with elevation of bone flap; for excision or coagulation of choroid 61544 Remove & treat brain lesion plexus 61545 Excision of brain tumor Craniotomy with elevation of bone flap; for excision of craniopharyngioma Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial 61546 Removal of pituitary gland approach Hypophysectomy or excision of pituitary tumor, transnasal or transseptal 61548 Removal of pituitary gland approach, nonstereotactic 61550 Release of skull seams Craniectomy for craniosynostosis; single cranial suture 61552 Release of skull seams Craniectomy for craniosynostosis; multiple cranial sutures 61556 Incise skull/sutures Craniotomy for craniosynostosis; frontal or parietal bone flap 61557 Incise skull/sutures Craniotomy for craniosynostosis; bifrontal bone flap Extensive craniectomy for multiple cranial suture craniosynostosis (eg, 61558 Excision of skull/sutures cloverleaf skull); not requiring bone grafts Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts 61559 Excision of skull/sutures (eg, barrel-stave procedure) (includes obtaining grafts) Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous 61563 Excision of skull tumor dysplasia); without optic nerve decompression Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous 61564 Excision of skull tumor dysplasia); with optic nerve decompression Craniotomy with elevation of bone flap; for selective 61566 Removal of brain tissue amygdalohippocampectomy Craniotomy with elevation of bone flap; for multiple subpial transections, with 61567 Incision of brain tissue electrocorticography during surgery 61570 Remove foreign body brain Craniectomy or craniotomy; with excision of foreign body from brain 61571 Incise skull for brain wound Craniectomy or craniotomy; with treatment of penetrating wound of brain Transoral approach to skull base, brain stem or upper spinal cord for biopsy, 61575 Skull base/brainstem surgery decompression or excision of lesion; Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or 61576 Skull base/brainstem surgery mandible (including tracheostomy) Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital 61580 Craniofacial approach skull exenteration Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or 61581 Craniofacial approach skull maxillectomy Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of 61582 Craniofacial approach skull anterior cranial fossa Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of 61583 Craniofacial approach skull base of anterior cranial fossa Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); 61584 Orbitocranial approach/skull without orbital exenteration Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); 61585 Orbitocranial approach/skull with orbital exenteration Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior 61586 Resect nasopharynx skull cranial fossa with or without internal fixation, without bone graft Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, 61590 Infratemporal approach/skull decompression and/or mobilization Page 4 of 10 Added to IP Only List Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with 61591 Infratemporal approach/skull or without decompression and

Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of 61592 Orbitocranial approach/skull zygoma, craniotomy, extra- or intradural elevation of temporal lobe Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or 61595 Transtemporal approach/skull facial nerve, with or without mobilization Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without 61596 Transcochlear approach/skull mobilization of facial nerve and/or petrous carotid artery Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompression of vertebral artery, with 61597 Transcondylar approach/skull or without mobilization Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, 61598 Transpetrosal approach/skull including ligation of superior petrosal sinus and/or sigmoid sinus Resection or excision of neoplastic, vascular or infectious lesion of base of 61600 Resect/excise cranial lesion anterior cranial fossa; extradural Resection or excision of neoplastic, vascular or infectious lesion of base of 61601 Resect/excise cranial lesion anterior cranial fossa; intradural, including dural repair, with or without graft Resection or excision of neoplastic, vascular or infectious lesion of 61605 Resect/excise cranial lesion infratemporal fossa, parapharyngeal space, petrous apex; extradural Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including 61606 Resect/excise cranial lesion dural repair, with or without graft Resection or excision of neoplastic, vascular or infectious lesion of parasellar 61607 Resect/excise cranial lesion area, cavernous sinus, clivus or midline skull base; extradural Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural 61608 Resect/excise cranial lesion repair, with or without graft Transection or ligation, carotid artery in cavernous sinus; without repair (List 61609 Transect artery sinus separately in addition to code for primary procedure)

Transection or ligation, carotid artery in cavernous sinus; with repair by 61610 Transect artery sinus anastomosis or graft (List separately in addition to code for primary procedure) Transection or ligation, carotid artery in petrous canal; without repair (List 61611 Transect artery sinus separately in addition to code for primary procedure)

Transection or ligation, carotid artery in petrous canal; with repair by 61612 Transect artery sinus anastomosis or graft (List separately in addition to code for primary procedure) Obliteration of carotid aneurysm, arteriovenous malformation, or carotid- 61613 Remove aneurysm sinus cavernous fistula by dissection within cavernous sinus Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral 61615 Resect/excise lesion skull bodies; extradural Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral 61616 Resect/excise lesion skull bodies; intradural, including dural repair, with or without graft Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or 61618 Repair dura synthetic grafts) Page 5 of 10 Added to IP Only List Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, 61619 Repair dura temporalis, frontalis or occi

Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, 61624 Transcath occlusion cns any method; central nervous system (intracranial, spinal cord)

61630 Intracranial angioplasty Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous Transcatheter placement of intravascular stent(s), intracranial (eg, 61635 Intracran angioplsty w/stent atherosclerotic stenosis), including balloon angioplasty, if performed Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s) 61645 Perq art m-thrombect &/nfs Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic 61650 Evasc prlng admn rx agnt 1st angiography, and imaging guidance; initial vascular territory Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List 61651 Evasc prlng admn rx agnt add separately in addition to code for primary procedure) 61680 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; supratentorial, simple 61682 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; supratentorial, complex 61684 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; infratentorial, simple 61686 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; infratentorial, complex 61690 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; dural, simple 61692 Intracranial vessel surgery Surgery of intracranial arteriovenous malformation; dural, complex Surgery of complex intracranial aneurysm, intracranial approach; carotid 61697 Brain aneurysm repr complx circulation Surgery of complex intracranial aneurysm, intracranial approach; 61698 Brain aneurysm repr complx vertebrobasilar circulation Surgery of simple intracranial aneurysm, intracranial approach; carotid 61700 Brain aneurysm repr simple circulation Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar 61702 Inner skull vessel surgery circulation Surgery of intracranial aneurysm, cervical approach by application of occluding 61703 Clamp neck artery clamp to cervical carotid artery (Selverstone-Crutchfield type) Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by 61705 Revise circulation to head intracranial and cervical occlusion of carotid artery Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by 61708 Revise circulation to head intracranial electrothrombosis Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by 61710 Revise circulation to head intra-arterial embolization, injection procedure, or balloon catheter Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) 61711 Fusion of skull arteries arteries Creation of lesion by stereotactic method, including burr hole(s) and localizing and recording techniques, single or multiple stages; subcortical structure(s) 61735 Incise skull/brain surgery other than globus pallidus or thalamus Stereotactic biopsy, aspiration, or excision, including burr hole(s), for 61750 Incise skull/brain biopsy intracranial lesion; Stereotactic biopsy, aspiration, or excision, including burr hole(s), for intracranial lesion; with computed tomography and/or magnetic resonance 61751 Brain biopsy w/ct/mr guide guidance Stereotactic implantation of depth electrodes into the cerebrum for long term 61760 Implant brain electrodes seizure monitoring Page 6 of 10 Added to IP Only List

61850 Implant neuroelectrodes Twist drill or burr hole(s) for implantation of neurostimulator electrodes, cortical Craniectomy or craniotomy for implantation of neurostimulator electrodes, 61860 Implant neuroelectrodes cerebral, cortical Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without 61863 Implant neuroelectrode use of intraoperat Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), without 61864 Implant neuroelectrde addl use of intraoperat Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of 61867 Implant neuroelectrode intraoperative Twist drill, burr hole, craniotomy, or craniectomy with stereotactic implantation of neurostimulator electrode array in subcortical site (eg, thalamus, globus pallidus, subthalamic nucleus, periventricular, periaqueductal gray), with use of 61868 Implant neuroelectrde addl intraoperative

61870 Implant neuroelectrodes Craniectomy for implantation of neurostimulator electrodes, cerebellar; cortical Craniectomy for implantation of neurostimulator electrodes, cerebellar; 61875 Implant neuroelectrodes subcortical 62005 Treat skull fracture Elevation of depressed skull fracture; compound or comminuted, extradural Elevation of depressed skull fracture; with repair of dura and/or debridement of 62010 Treatment of head injury brain Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for 62100 Repair brain fluid leakage rhinorrhea/otorrhea Reduction of craniomegalic skull (eg, treated hydrocephalus); not requiring 62115 Reduction of skull defect bone grafts or cranioplasty Reduction of craniomegalic skull (eg, treated hydrocephalus); with simple 62116 Reduction of skull defect cranioplasty Reduction of craniomegalic skull (eg, treated hydrocephalus); requiring craniotomy and reconstruction with or without bone graft (includes obtaining 62117 Reduction of skull defect grafts) 62120 Repair skull cavity lesion Repair of encephalocele, skull vault, including cranioplasty 62121 Incise skull repair Craniotomy for repair of encephalocele, skull base 62140 Repair of skull defect Cranioplasty for skull defect; up to 5 cm diameter 62141 Repair of skull defect Cranioplasty for skull defect; larger than 5 cm diameter 62142 Remove skull plate/flap Removal of bone flap or prosthetic plate of skull 62143 Replace skull plate/flap Replacement of bone flap or prosthetic plate of skull 62145 Repair of skull & brain Cranioplasty for skull defect with reparative brain surgery Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm 62146 Repair of skull with graft diameter Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm 62147 Repair of skull with graft diameter Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List 62148 Retr bone flap to fix skull separately in addition to code for primary procedure) Neuroendoscopy, intracranial; with dissection of adhesions, fenestration of septum pellucidum or intraventricular cysts (including placement, replacement, 62161 Dissect brain w/scopc or removal of ventricular catheter) Neuroendoscopy, intracranial; with fenestration or excision of colloid cyst, 62162 Remove colloid cyst w/scope including placement of external ventricular catheter for drainage 62163 Neuroendoscopy w/fb removal Neuroendoscopy, intracranial; with retrieval of foreign body Neuroendoscopy, intracranial; with excision of brain tumor, including 62164 Remove brain tumor w/scope placement of external ventricular catheter for drainage Page 7 of 10 Added to IP Only List Neuroendoscopy, intracranial; with excision of pituitary tumor, transnasal or 62165 Remove pituit tumor w/scope trans-sphenoidal approach 62180 Establish brain cavity shunt Ventriculocisternostomy (Torkildsen type operation) 62190 Establish brain cavity shunt Creation of shunt; subarachnoid/subdural-atrial, -jugular, -auricular

62192 Establish brain cavity shunt Creation of shunt; subarachnoid/subdural-peritoneal, -pleural, other terminus 62200 Establish brain cavity shunt Ventriculocisternostomy, third ventricle;

62201 Brain cavity shunt w/scope Ventriculocisternostomy, third ventricle; stereotactic, neuroendoscopic method 62220 Establish brain cavity shunt Creation of shunt; ventriculo-atrial, -jugular, -auricular 62223 Establish brain cavity shunt Creation of shunt; ventriculo-peritoneal, -pleural, other terminus 62256 Remove brain cavity shunt Removal of complete cerebrospinal fluid shunt system; without replacement Removal of complete cerebrospinal fluid shunt system; with replacement by 62258 Replace brain cavity shunt similar or other shunt at same operation Laminoplasty, cervical, with decompression of the spinal cord, two or more 63050 Cervical laminoplsty 2/> seg vertebral segments; Laminoplasty, cervical, with decompression of the spinal cord, two or more vertebral segments; with reconstruction of the posterior bony elements (including the application of bridging bone graft and non-segmental fixation 63051 C-laminoplasty w/graft/plate devices (eg, wire, suture, mini- Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), 63077 Spine disk surgery thorax including osteophytectomy; thoracic, single interspace Discectomy, anterior, with decompression of spinal cord and/or nerve root(s), including osteophytectomy; thoracic, each additional interspace (List 63078 Spine disk surgery thorax separately in addition to code for primary procedure) Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, 63081 Remove vert body dcmprn crvl single segment Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in addition to code for primary 63082 Remove vertebral body add-on procedure) Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); 63085 Remove vert body dcmprn thrc thoracic, single segment Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately in addition to code for 63086 Remove vertebral body add-on primary procedure) Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or 63087 Remov vertbr dcmprn thrclmbr nerve root(s), lower thoracic or lumbar; single segment Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (List 63088 Remove vertebral body add-on separately in addition to code Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single 63090 Remove vert body dcmprn lmbr segment Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each 63091 Remove vertebral body add-on additional segment (List separately

Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) 63101 Remove vert body dcmprn thrc (eg, for tumor or retropulsed bone fragments); thoracic, single segment Page 8 of 10 Added to IP Only List

Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) 63102 Remove vert body dcmprn lmbr (eg, for tumor or retropulsed bone fragments); lumbar, single segment Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each 63103 Remove vertebral body add-on additional segment (List se Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or 63170 Incise spinal cord tract(s) thoracolumbar Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid 63172 Drainage of spinal cyst space Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or 63173 Drainage of spinal cyst pleural space Laminectomy and section of dentate ligaments, with or without dural graft, 63180 Revise spinal cord ligaments cervical; one or two segments Laminectomy and section of dentate ligaments, with or without dural graft, 63182 Revise spinal cord ligaments cervical; more than two segments 63185 Incise spine nrv half segmnt Laminectomy with rhizotomy; one or two segments 63190 Incise spine nrv >2 segmnts Laminectomy with rhizotomy; more than two segments 63191 Incise spine accessory nerve Laminectomy with section of spinal accessory nerve Laminectomy with cordotomy, with section of one spinothalamic tract, one 63194 Incise spine & cord cervical stage; cervical Laminectomy with cordotomy, with section of one spinothalamic tract, one 63195 Incise spine & cord thoracic stage; thoracic Laminectomy with cordotomy, with section of both spinothalamic tracts, one 63196 Incise spine&cord 2 trx crvl stage; cervical Laminectomy with cordotomy, with section of both spinothalamic tracts, one 63197 Incise spine&cord 2 trx thrc stage; thoracic Laminectomy with cordotomy with section of both spinothalamic tracts, two 63198 Incise spin&cord 2 stgs crvl stages within 14 days; cervical Laminectomy with cordotomy with section of both spinothalamic tracts, two 63199 Incise spin&cord 2 stgs thrc stages within 14 days; thoracic 63200 Release spinal cord lumbar Laminectomy, with release of tethered spinal cord, lumbar Laminectomy for excision or occlusion of arteriovenous malformation of spinal 63250 Revise spinal cord vessels cord; cervical Laminectomy for excision or occlusion of arteriovenous malformation of spinal 63251 Revise spinal cord vsls thrc cord; thoracic Laminectomy for excision or occlusion of arteriovenous malformation of spinal 63252 Revise spine cord vsl thrlmb cord; thoracolumbar Laminectomy for excision or evacuation of intraspinal lesion other than 63265 Excise intraspinl lesion crv neoplasm, extradural; cervical Laminectomy for excision or evacuation of intraspinal lesion other than 63266 Excise intrspinl lesion thrc neoplasm, extradural; thoracic Laminectomy for excision or evacuation of intraspinal lesion other than 63267 Excise intrspinl lesion lmbr neoplasm, extradural; lumbar Laminectomy for excision or evacuation of intraspinal lesion other than 63268 Excise intrspinl lesion scrl neoplasm, extradural; sacral Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; 63270 Excise intrspinl lesion crvl cervical Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; 63271 Excise intrspinl lesion thrc thoracic Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; 63272 Excise intrspinl lesion lmbr lumbar Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; 63273 Excise intrspinl lesion scrl sacral

63275 Bx/exc xdrl spine lesn crvl Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical Page 9 of 10 Added to IP Only List

63276 Bx/exc xdrl spine lesn thrc Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic

63277 Bx/exc xdrl spine lesn lmbr Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar 63278 Bx/exc xdrl spine lesn scrl Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63280 Bx/exc idrl spine lesn crvl extramedullary, cervical Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63281 Bx/exc idrl spine lesn thrc extramedullary, thoracic Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63282 Bx/exc idrl spine lesn lmbr extramedullary, lumbar 63283 Bx/exc idrl spine lesn scrl Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63285 Bx/exc idrl imed lesn cervl intramedullary, cervical Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63286 Bx/exc idrl imed lesn thrc intramedullary, thoracic Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, 63287 Bx/exc idrl imed lesn thrlmb intramedullary, thoracolumbar Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural- 63290 Bx/exc xdrl/idrl lsn any lvl intradural lesion, any level Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary 63295 Repair of laminectomy defect procedure) Vertebral corpectomy (vertebral body resection), partial or complete, for 63300 Remove vert xdrl body crvcl excision of intraspinal lesion, single segment; extradural, cervical Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by 63301 Remove vert xdrl body thrc transthoracic approach Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by 63302 Remove vert xdrl body thrlmb thoracolumbar approach Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by 63303 Remov vert xdrl bdy lmbr/sac transperitoneal or retroperitoneal approach Vertebral corpectomy (vertebral body resection), partial or complete, for 63304 Remove vert idrl body crvcl excision of intraspinal lesion, single segment; intradural, cervical Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by 63305 Remove vert idrl body thrc transthoracic approach Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by 63306 Remov vert idrl bdy thrclmbr thoracolumbar approach Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by 63307 Remov vert idrl bdy lmbr/sac transperitoneal or retroperitoneal approach Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List 63308 Remove vertebral body add-on separately in addition to codes for single segment) 63700 Repair of spinal herniation Repair of meningocele; less than 5 cm diameter 63702 Repair of spinal herniation Repair of meningocele; larger than 5 cm diameter 63704 Repair of spinal herniation Repair of myelomeningocele; less than 5 cm diameter 63706 Repair of spinal herniation Repair of myelomeningocele; larger than 5 cm diameter 63707 Repair spinal fluid leakage Repair of dural/cerebrospinal fluid leak, not requiring laminectomy Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with 63709 Repair spinal fluid leakage laminectomy 63710 Graft repair of spine defect Dural graft, spinal Creation of shunt, lumbar, subarachnoid-peritoneal, -pleural, or other; including 63740 Install spinal shunt laminectomy Page 10 of 10 Added to IP Only List 64752 Incision of vagus nerve Transection or avulsion of; vagus nerve (vagotomy), transthoracic Transection or avulsion of; vagus nerves limited to proximal stomach (selective proximal vagotomy, proximal gastric vagotomy, parietal cell vagotomy, supra- 64755 Incision of stomach nerves or highly selective vagotomy) 64760 Incision of vagus nerve Transection or avulsion of; vagus nerve (vagotomy), abdominal 64809 Remove sympathetic nerves Sympathectomy, thoracolumbar 64818 Remove sympathetic nerves Sympathectomy, lumbar 64866 Fusion of facial/other nerve Anastomosis; facial-spinal accessory 64868 Fusion of facial/other nerve Anastomosis; facial-hypoglossal Page 1 of 1 Medicare IP Only List 2019 Newborn and Pediatric Care Services CPT/ Short HCPCS Description Long Description Added to IP Only List Initial inpatient neonatal critical care, per day, for the Neonate crit care evaluation and management of a critically ill neonate, 28 99468 initial days of age or younger Subsequent inpatient neonatal critical care, per day, for Neonate crit care the evaluation and management of a critically ill neonate, 99469 subsq 28 days of age or younger Initial inpatient pediatric critical care, per day, for the Ped critical care evaluation and management of a critically ill infant or 99471 initial young child, 29 days through 24 months of age Subsequent inpatient pediatric critical care, per day, for Ped critical care the evaluation and management of a critically ill infant or 99472 subsq young child, 29 days through 24 months of age Initial inpatient pediatric critical care, per day, for the Ped crit care age evaluation and management of a critically ill infant or 99475 2-5 init young child, 2 through 5 years of age Subsequent inpatient pediatric critical care, per day, for Ped crit care age the evaluation and management of a critically ill infant or 99476 2-5 subsq young child, 2 through 5 years of age Initial hospital care, per day, for the evaluation and management of the neonate, 28 days of age or younger, Init day hosp who requires intensive observation, frequent 99477 neonate care interventions, and other intensive care services

Subsequent intensive care, per day, for the evaluation Ic lbw inf < 1500 and management of the recovering very low birth weight 99478 gm subsq infant (present body weight less than 1500 grams) Subsequent intensive care, per day, for the evaluation Ic lbw inf 1500- and management of the recovering low birth weight 99479 2500 g subsq infant (present body weight of 1500-2500 grams) Subsequent intensive care, per day, for the evaluation Ic inf pbw 2501- and management of the recovering infant (present body 99480 5000 g subsq weight of 2501-5000 grams) Page 1 of 5 Medicare IP Only List 2019 Respiratory System CPT/ HCPCS Short Description Long Description 31225 Removal of upper jaw Maxillectomy; without orbital exenteration 31230 Removal of upper jaw Maxillectomy; with orbital exenteration (en bloc) Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid 31290 Nasal/sinus endoscopy surg leak; ethmoid region Nasal/sinus endoscopy, surgical, with repair of cerebrospinal fluid 31291 Nasal/sinus endoscopy surg leak; sphenoid region 31360 Removal of larynx Laryngectomy; total, without radical neck dissection 31365 Removal of larynx Laryngectomy; total, with radical neck dissection 31367 Partial removal of larynx Laryngectomy; subtotal supraglottic, without radical neck dissection 31368 Partial removal of larynx Laryngectomy; subtotal supraglottic, with radical neck dissection 31370 Partial removal of larynx Partial laryngectomy (hemilaryngectomy); horizontal 31375 Partial removal of larynx Partial laryngectomy (hemilaryngectomy); laterovertical 31380 Partial removal of larynx Partial laryngectomy (hemilaryngectomy); anterovertical 31382 Partial removal of larynx Partial laryngectomy (hemilaryngectomy); antero-latero-vertical Removal of larynx & Pharyngolaryngectomy, with radical neck dissection; without 31390 pharynx reconstruction Reconstruct larynx & Pharyngolaryngectomy, with radical neck dissection; with 31395 pharynx reconstruction Catheter aspiration (separate procedure); tracheobronchial with 31725 Clearance of airways fiberscope, bedside 31760 Repair of windpipe Tracheoplasty; intrathoracic 31766 Reconstruction of windpipe Carinal reconstruction 31770 Repair/graft of bronchus Bronchoplasty; graft repair 31775 Reconstruct bronchus Bronchoplasty; excision stenosis and anastomosis 31780 Reconstruct windpipe Excision tracheal stenosis and anastomosis; cervical 31781 Reconstruct windpipe Excision tracheal stenosis and anastomosis; cervicothoracic 31786 Remove windpipe lesion Excision of tracheal tumor or carcinoma; thoracic 31800 Repair of windpipe injury Suture of tracheal wound or injury; cervical 31805 Repair of windpipe injury Suture of tracheal wound or injury; intrathoracic Thoracostomy w/rib 32035 resection Thoracostomy; with rib resection for empyema Thoracostomy w/flap 32036 drainage Thoracostomy; with open flap drainage for empyema Thoracotomy, with diagnostic biopsy(ies) of lung infiltrate(s) (eg, 32096 Open wedge/bx lung infiltr wedge, incisional), unilateral Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or 32097 Open wedge/bx lung nodule mass(es) (eg, wedge, incisional), unilateral Thoracotomy, with biopsy(ies) of pleura 32098 Open biopsy of lung pleura 32100 Exploration/biopsy of chest Thoracotomy, major; with exploration and biopsy Thoracotomy, major; with control of traumatic hemorrhage and/or 32110 Explore/repair chest repair of lung tear 32120 Re-exploration of chest Thoracotomy, major; for postoperative complications Page 2 of 5 CPT/ HCPCS Short Description Long Description Explore chest free 32124 adhesions Thoracotomy, major; with open intrapleural pneumonolysis Thoracotomy, major; with cyst(s) removal, with or without a pleural 32140 Removal of lung lesion(s) procedure Thoracotomy, major; with excision-plication of bullae, with or without 32141 Remove/treat lung lesions any pleural procedure Thoracotomy, major; with removal of intrapleural foreign body or fibrin 32150 Removal of lung lesion(s) deposit 32151 Remove lung foreign body Thoracotomy, major; with removal of intrapulmonary foreign body 32160 Open chest heart massage Thoracotomy, major; with cardiac massage 32200 Drain open lung lesion Pneumonostomy; with open drainage of abscess or cyst 32215 Treat chest lining Pleural scarification for repeat pneumothorax 32220 Release of lung Decortication, pulmonary (separate procedure); total 32225 Partial release of lung Decortication, pulmonary (separate procedure); partial 32310 Removal of chest lining Pleurectomy, parietal (separate procedure) 32320 Free/remove chest lining Decortication and parietal pleurectomy Remove lung 32440 pneumonectomy Removal of lung, total pneumonectomy; Removal of lung, total pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve 32442 Sleeve pneumonectomy pneumonectomy) Removal of lung 32445 extrapleural Removal of lung, total pneumonectomy; extrapleural Removal of lung, other than total pneumonectomy; single lobe 32480 Partial removal of lung (lobectomy) Removal of lung, other than total pneumonectomy; two lobes 32482 Bilobectomy (bilobectomy) Removal of lung, other than total pneumonectomy; single segment 32484 Segmentectomy (segmentectomy) Removal of lung, other than total pneumonectomy; with circumferential resection of segment of bronchus followed by broncho- 32486 Sleeve lobectomy bronchial anastomosis (sleeve lobectomy) Removal of lung, other than total pneumonectomy; all remaining lung Completion following previous removal of a portion of lung (completion 32488 pneumonectomy pneumonectomy) Removal of lung, other than total pneumonectomy; excision-plication of emphysematous lung(s) (bullous or non-bullous) for lung volume reduction, sternal split or transthoracic approach, with or without any 32491 Lung volume reduction pleural procedure Resection and repair of portion of bronchus (bronchoplasty) when performed at time of lobectomy or segmentectomy (List separately in 32501 Repair bronchus add-on addition to code for primary procedure) Resection of apical lung tumor (eg, Pancoast tumor), including chest wall resection, rib(s) resection(s), neurovascular dissection, when 32503 Resect apical lung tumor performed; without chest wall reconstruction(s) Page 3 of 5 CPT/ HCPCS Short Description Long Description Resection of apical lung tumor (eg, Pancoast tumor), including chest Resect apical lung wall resection, rib(s) resection(s), neurovascular dissection, when 32504 tum/chest performed; with chest wall reconstruction Thoracotomy; with therapeutic wedge resection (eg, mass, nodule), 32505 Wedge resect of lung initial initial Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), Wedge resect of lung add- each additional resection, ipsilateral (list separately in addition to code 32506 on for primary procedure) Thoracotomy; with diagnostic wedge resection followed by anatomic lung resection (list separately in addition to code for primary 32507 Wedge resect of lung diag procedure) 32540 Removal of lung lesion Extrapleural enucleation of empyema (empyemectomy)

32650 Thoracoscopy w/pleurodesis Thoracoscopy, surgical; with pleurodesis (eg, mechanical or chemical) Thoracoscopy remove 32651 cortex Thoracoscopy, surgical; with partial pulmonary decortication Thoracoscopy rem totl Thoracoscopy, surgical; with total pulmonary decortication, including 32652 cortex intrapleural pneumonolysis Thoracoscopy remov Thoracoscopy, surgical; with removal of intrapleural foreign body or 32653 fb/fibrin fibrin deposit Thoracoscopy contrl 32654 bleeding Thoracoscopy, surgical; with control of traumatic hemorrhage Thoracoscopy, surgical; with excision-plication of bullae, including any 32655 Thoracoscopy resect bullae pleural procedure Thoracoscopy 32656 w/pleurectomy Thoracoscopy, surgical; with parietal pleurectomy Thoracoscopy w/sac fb Thoracoscopy, surgical; with removal of clot or foreign body from 32658 remove pericardial sac Thoracoscopy w/sac Thoracoscopy, surgical; with creation of pericardial window or partial 32659 drainage resection of pericardial sac for drainage Thoracoscopy w/pericard Thoracoscopy, surgical; with excision of pericardial cyst, tumor, or 32661 exc mass Thoracoscopy w/mediast Thoracoscopy, surgical; with excision of mediastinal cyst, tumor, or 32662 exc mass 32663 Thoracoscopy w/lobectomy Thoracoscopy, surgical; with lobectomy, total or segmental 32664 Thoracoscopy w/ th nrv exc Thoracoscopy, surgical; with thoracic sympathectomy Thoracoscop w/esoph musc 32665 exc Thoracoscopy, surgical; with esophagomyotomy (Heller type) Thoracoscopy w/wedge Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass, 32666 resect nodule), initial unilateral Thoracoscopy, surgical; with therapeutic wedge resection (eg, mass or Thoracoscopy w/w resect nodule), each additional resection, ipsilateral (list separately in 32667 addl addition to code for primary procedure) Thoracoscopy, surgical; with diagnostic wedge resection followed by Thoracoscopy w/w resect anatomic lung resection (list separately in addition to code for primary 32668 diag procedure) Page 4 of 5 CPT/ HCPCS Short Description Long Description Thoracoscopy remove Thoracoscopy, surgical; with removal of a single lung segment 32669 segment (segmentectomy) 32670 Thoracoscopy bilobectomy Thoracoscopy, surgical; with removal of two lobes (bilobectomy) Thoracoscopy 32671 pneumonectomy Thoracoscopy, surgical; with removal of lung (pneumonectomy) Page 5 of 5 CPT/ HCPCS Short Description Long Description Thoracoscopy, surgical; with resection-plication for emphysematous lung (bullous or non-bullous) for lung volume reduction (lvrs), 32672 Thoracoscopy for lvrs unilateral includes any pleural procedure, when performed Thoracoscopy w/thymus 32673 resect Thoracoscopy, surgical; with resection of thymus, unilateral or bilateral Thoracoscopy, surgical; with mediastinal and regional Thoracoscopy lymph node lymphadenectomy (list separately in addition to code for primary 32674 exc procedure) 32800 Repair lung hernia Repair lung hernia through chest wall Closure of chest wall following open flap drainage for empyema 32810 Close chest after drainage (Clagett type procedure) 32815 Close bronchial fistula Open closure of major bronchial fistula 32820 Reconstruct injured chest Major reconstruction, chest wall (posttraumatic) Donor pneumonectomy(s) (including cold preservation), from cadaver 32850 Donor pneumonectomy donor 32851 Lung transplant single Lung transplant, single; without cardiopulmonary bypass

32852 Lung transplant with bypass Lung transplant, single; with cardiopulmonary bypass Lung transplant, double (bilateral sequential or en bloc); without 32853 Lung transplant double cardiopulmonary bypass Lung transplant, double (bilateral sequential or en bloc); with 32854 Lung transplant with bypass cardiopulmonary bypass Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, 32855 Prepare donor lung single and bronchus; unilateral Backbench standard preparation of cadaver donor lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare pulmonary venous/atrial cuff, pulmonary artery, 32856 Prepare donor lung double and bronchus; bilateral 32900 Removal of rib(s) Resection of ribs, extrapleural, all stages 32905 Revise & repair chest wall Thoracoplasty, Schede type or extrapleural (all stages); Thoracoplasty, Schede type or extrapleural (all stages); with closure of 32906 Revise & repair chest wall bronchopleural fistula

32940 Revision of lung Pneumonolysis, extraperiosteal, including filling or packing procedures 32997 Total lung lavage Total lung lavage (unilateral) Mediastinotomy with exploration, drainage, removal of foreign body, or 39000 Exploration of chest biopsy; cervical approach Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or 39010 Exploration of chest median sternotomy Page 1 of 5 Medicare IP Only List 2019 Urinary System CPT/ HCPCS Short Description Long Description Removed from IP Only list 50010 Exploration of kidney Renal exploration, not necessitating other specific procedures 50040 Drainage of kidney Nephrostomy, nephrotomy with drainage 50045 Exploration of kidney Nephrotomy, with exploration 50060 Removal of kidney stone Nephrolithotomy; removal of calculus 50065 Incision of kidney Nephrolithotomy; secondary surgical operation for calculus 50070 Incision of kidney Nephrolithotomy; complicated by congenital kidney abnormality Nephrolithotomy; removal of large staghorn calculus filling renal pelvis 50075 Removal of kidney stone and calyces (including anatrophic pyelolithotomy) Transection or repositioning of aberrant renal vessels (separate 50100 Revise kidney blood vessels procedure) 50120 Exploration of kidney Pyelotomy; with exploration 50125 Explore and drain kidney Pyelotomy; with drainage, pyelostomy Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, 50130 Removal of kidney stone including coagulum pyelolithotomy) Pyelotomy; complicated (eg, secondary operation, congenital kidney 50135 Exploration of kidney abnormality) 50205 Renal biopsy open Renal biopsy; by surgical exposure of kidney Nephrectomy, including partial ureterectomy, any open approach 50220 Remove kidney open including rib resection; Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on 50225 Removal kidney open complex same kidney Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or 50230 Removal kidney open radical vena caval thrombectomy Nephrectomy with total ureterectomy and bladder cuff; through same 50234 Removal of kidney & ureter incision Nephrectomy with total ureterectomy and bladder cuff; through 50236 Removal of kidney & ureter separate incision 50240 Partial removal of kidney Nephrectomy, partial Ablation, open, one or more renal mass lesion(s), cryosurgical, 50250 Cryoablate renal mass open including intraoperative ultrasound, if performed 50280 Removal of kidney lesion Excision or unroofing of cyst(s) of kidney 50290 Removal of kidney lesion Excision of perinephric cyst Donor nephrectomy (including cold preservation); from cadaver donor, 50300 Remove cadaver donor kidney unilateral or bilateral Page 2 of 5 Removed from IP Only list Donor nephrectomy (including cold preservation); open, from living 50320 Remove kidney living donor donor Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal 50323 Prep cadaver renal allograft gland, and preparation of ureter(s), renal ve Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal 50325 Prep donor renal graft artery(s), ligating branches, as nec Backbench reconstruction of cadaver or living donor renal allograft 50327 Prep renal graft/venous prior to transplantation; venous anastomosis, each Backbench reconstruction of cadaver or living donor renal allograft 50328 Prep renal graft/arterial prior to transplantation; arterial anastomosis, each Backbench reconstruction of cadaver or living donor renal allograft 50329 Prep renal graft/ureteral prior to transplantation; ureteral anastomosis, each 50340 Removal of kidney Recipient nephrectomy (separate procedure) Renal allotransplantation, implantation of graft; without recipient 50360 Transplantation of kidney nephrectomy Renal allotransplantation, implantation of graft; with recipient 50365 Transplantation of kidney nephrectomy 50370 Remove transplanted kidney Removal of transplanted renal allograft 50380 Reimplantation of kidney Renal autotransplantation, reimplantation of kidney Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, 50400 Revision of kidney/ureter pyelostomy, or ureteral splinting; simple Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney 50405 Revision of kidney/ureter abnormality, secondary pyeloplasty, solitary kidn 50500 Repair of kidney wound Nephrorrhaphy, suture of kidney wound or injury 50520 Close kidney-skin fistula Closure of nephrocutaneous or pyelocutaneous fistula Closure of nephrovisceral fistula (eg, renocolic), including visceral 50525 Repair renal-abdomen fistula repair; abdominal approach Closure of nephrovisceral fistula (eg, renocolic), including visceral 50526 Repair renal-abdomen fistula repair; thoracic approach Symphysiotomy for horseshoe kidney with or without pyeloplasty 50540 Revision of horseshoe kidney and/or other plastic procedure, unilateral or bilateral (one operation) Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph 50545 Laparo radical nephrectomy nodes, and adrenalectomy) Page 3 of 5 Removed from IP Only list 50546 Laparoscopic nephrectomy Laparoscopy, surgical; nephrectomy, including partial ureterectomy Laparoscopy, surgical; donor nephrectomy (including cold 50547 Laparo removal donor kidney preservation), from living donor 50548 Laparo remove w/ureter Laparoscopy, surgical; nephrectomy with total ureterectomy 50600 Exploration of ureter Ureterotomy with exploration or drainage (separate procedure) 50605 Insert ureteral support Ureterotomy for insertion of indwelling stent, all types 50610 Removal of ureter stone Ureterolithotomy; upper one-third of ureter 50620 Removal of ureter stone Ureterolithotomy; middle one-third of ureter 50630 Removal of ureter stone Ureterolithotomy; lower one-third of ureter 50650 Removal of ureter Ureterectomy, with bladder cuff (separate procedure) Ureterectomy, total, ectopic ureter, combination abdominal, vaginal 50660 Removal of ureter and/or perineal approach 50700 Revision of ureter Ureteroplasty, plastic operation on ureter (eg, stricture) Ureterolysis, with or without repositioning of ureter for retroperitoneal 50715 Release of ureter fibrosis 50722 Release of ureter Ureterolysis for ovarian vein syndrome Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary 50725 Release/revise ureter tract or vena cava Revision of urinary-cutaneous anastomosis (any type urostomy); with 50728 Revise ureter repair of fascial defect and hernia 50740 Fusion of ureter & kidney Ureteropyelostomy, anastomosis of ureter and renal pelvis 50750 Fusion of ureter & kidney Ureterocalycostomy, anastomosis of ureter to renal calyx 50760 Fusion of ureters Ureteroureterostomy Transureteroureterostomy, anastomosis of ureter to contralateral 50770 Splicing of ureters ureter 50780 Reimplant ureter in bladder Ureteroneocystostomy; anastomosis of single ureter to bladder 50782 Reimplant ureter in bladder Ureteroneocystostomy; anastomosis of duplicated ureter to bladder 50783 Reimplant ureter in bladder Ureteroneocystostomy; with extensive ureteral tailoring 50785 Reimplant ureter in bladder Ureteroneocystostomy; with vesico-psoas hitch or bladder flap 50800 Implant ureter in bowel Ureteroenterostomy, direct anastomosis of ureter to intestine Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine 50810 Fusion of ureter & bowel anastomosis 50815 Urine shunt to intestine Ureterocolon conduit, including intestine anastomosis Ureteroileal conduit (ileal bladder), including intestine anastomosis 50820 Construct bowel bladder (Bricker operation) Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey 50825 Construct bowel bladder enterocystoplasty) Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy 50830 Revise urine flow or ureteroneocystostomy) Page 4 of 5 Removed from IP Only list Replacement of all or part of ureter by intestine segment, including 50840 Replace ureter by bowel intestine anastomosis 50845 Appendico-vesicostomy Cutaneous appendico-vesicostomy 50860 Transplant ureter to skin Ureterostomy, transplantation of ureter to skin 50900 Repair of ureter Ureterorrhaphy, suture of ureter (separate procedure) 50920 Closure ureter/skin fistula Closure of ureterocutaneous fistula 50930 Closure ureter/bowel fistula Closure of ureterovisceral fistula (including visceral repair) 50940 Release of ureter Deligation of ureter Cystotomy; for excision of bladder diverticulum, single or multiple 51525 Removal of bladder lesion (separate procedure) 51530 Removal of bladder lesion Cystotomy; for excision of bladder tumor 51550 Partial removal of bladder Cystectomy, partial; simple Cystectomy, partial; complicated (eg, postradiation, previous surgery, 51555 Partial removal of bladder difficult location) Cystectomy, partial, with reimplantation of ureter(s) into bladder 51565 Revise bladder & ureter(s) (ureteroneocystostomy) 51570 Removal of bladder Cystectomy, complete; (separate procedure) Cystectomy, complete; with bilateral pelvic lymphadenectomy, 51575 Removal of bladder & nodes including external iliac, hypogastric, and obturator nodes Cystectomy, complete, with ureterosigmoidostomy or 51580 Remove bladder/revise tract ureterocutaneous transplantations; Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator 51585 Removal of bladder & nodes nodes Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, 51590 Remove bladder/revise tract including intestine anastomosis;

Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, 51595 Remove bladder/revise tract including external iliac, hypogastric, and obturator nodes Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct 51596 Remove bladder/create pouch neobladder Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum 51597 Removal of pelvic structures and colon and colostomy, or any combination there Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any 51800 Revision of bladder/urethra procedure, with or without wedge resection of posterior vesical neck Page 5 of 5 Removed from IP Only list 51820 Revision of urinary tract Cystourethroplasty with unilateral or bilateral ureteroneocystostomy Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti- 51840 Attach bladder/urethra Krantz, Burch); simple Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti- 51841 Attach bladder/urethra Krantz, Burch); complicated (eg, secondary repair)

51865 Repair of bladder wound Cystorrhaphy, suture of bladder wound, injury or rupture; complicated 51900 Repair bladder/vagina lesion Closure of vesicovaginal fistula, abdominal approach 51920 Close bladder-uterus fistula Closure of vesicouterine fistula; 51925 Hysterectomy/bladder repair Closure of vesicouterine fistula; with hysterectomy 51940 Correction of bladder defect Closure, exstrophy of bladder 51960 Revision of bladder & bowel Enterocystoplasty, including intestinal anastomosis 51980 Construct bladder opening Cutaneous vesicostomy Urethroplasty, transpubic or perineal, one stage, for reconstruction or 53415 Reconstruction of urethra repair of prostatic or membranous urethra Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of 53448 Remov/replc ur sphinctr comp infected tissue