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SJH Procedures SJH Procedures - General Service New Name Old Name CPT Code Service ABLATION, LESION, PERIRECTAL, USING CO2 LASER LASER VAPORIZATION RECTAL/PERIRECTAL AREA W CO2 LASER 45190 Destruction of rectal tumor (eg, electrodesiccation, General, Colorectal electrosurgery, laser ablation, laser resection, cryosurgery) transanal approach ADRENALECTOMY ADRENALECTOMY *60540 Adrenalectomy, partial or complete, or exploration of adrenal Urology, General gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); ADRENALECTOMY, LAPAROSCOPIC ADRENALECTOMY LAPAROSCOPY *60650 Laparoscopy, surgical, with adrenalectomy, partial or Urology, General complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal ADRENALECTOMY, ROBOT-ASSISTED, USING XI ADRENALECTOMY COMPLETE/PARTIAL W XI ROBOTICS *60650 Laparoscopy, surgical, with adrenalectomy, partial or Urology Robotics, General complete, or exploration of adrenal gland with or without Robotics biopsy, transabdominal, lumbar or dorsal ADVANCEMENT, FLAP, ENDORECTAL FLAP ENDORECTAL ADVANCEMENT 46288 Closure of anal fistula with rectal advancement flap Colorectal, General AMPUTATION, FOOT, TRANSMETATARSAL AMPUTATION TRANSMETATARSAL 28805 Amputation, foot; transmetatarsal Vascular, General, Orthopedics, Podiatry APPENDECTOMY, LAPAROSCOPIC APPENDECTOMY LAPAROSCOPY 44970 Laparoscopy, surgical, appendectomy General, Bariatric APPENDECTOMY, OPEN APPENDECTOMY OPEN 44950 Appendectomy; General 44955 Appendectomy; when done for indicated purpose at time of General other major procedure (not as separate procedure) (List separately in addition to code for primary procedure) *44960 Appendectomy; for ruptured appendix with abscess or General generalized peritonitis APPLICATION, APLIGRAF GRAFT APPLICATION APLIGRAF 15271 Application of skin substitute graft to trunk, arms, legs, total General wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area 15272 Application of skin substitute graft to trunk, arms, legs, total General wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separately in addition to code for primary procedure) 15273 Application of skin substitute graft to trunk, arms, legs, total General wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children 15274 Application of skin substitute graft to trunk, arms, legs, total General wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part thereof, or each additional 1% of body area of infants and children, or part ther 15275 Application of skin substitute graft to face, scalp, eyelids, General mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area 15276 Application of skin substitute graft to face, scalp, eyelids, General mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List separatel Page 1 of 38 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - General Service New Name Old Name CPT Code Service APPLICATION, APLIGRAF GRAFT APPLICATION APLIGRAF 15277 Application of skin substitute graft to face, scalp, eyelids, General mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of 15278 Application of skin substitute graft to face, scalp, eyelids, General mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits, total wound surface area greater than or equal to 100 sq cm; each additional 100 sq cm wound surface area, or part the APPLICATION, GRAFT, SKIN, SPLIT-THICKNESS GRAFT SKIN SPLIT THICKNESS 15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or Plastics, General, Vascular, ENT less, or 1% of body area of infants and children (except 15050) 15101 Split-thickness autograft, trunk, arms, legs; each additional 100 Plastics, General, Vascular, ENT sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, Plastics, General, Vascular, ENT ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) 15121 Split-thickness autograft, face, scalp, eyelids, mouth, neck, Plastics, General, Vascular, ENT ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition BIOPSY OR EXCISION, LESION, FACE AND NECK EXCISION/BIOPSY (MASS/LESION/LIPOMA/CYST) FACE/NECK General, Gynecology, Plastics, ENT, Maxillofacial BIOPSY OR EXCISION, LESION, FACE AND NECK, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE FACE/NECK 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, single lesion Aesthetics, Urology, Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, each separate/additional lesion (list separately in addition to Aesthetics, Urology, code for primary procedure) Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11104 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); single lesion Aesthetics, Urology, Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11105 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); each separate/additional lesion (list separately in Aesthetics, Urology, addition to code for primary procedure) Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics Page 2 of 38 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - General Service New Name Old Name CPT Code Service BIOPSY OR EXCISION, LESION, FACE AND NECK, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE FACE/NECK 11106 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Gynecology, when performed); single lesion Aesthetics, Urology, Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics 11107 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Gynecology, when performed); each separate/additional lesion (list Aesthetics, Urology, separately in addition to code for primary procedure) Maxillofacial, ENT, Thoracic, Vascular, Cardiovascular, Plastics, Orthopedics BIOPSY OR EXCISION, LESION, FACE AND NECK, USING CO2 LASER EXCISE/BIOPSY(MASS/LESION/LIPOMA/CYST) FACE/NECK W CO2 LASER 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Aesthetics, single lesion Cardiovascular, Colorectal, ENT, Maxillofacial, Plastics, Orthopedics, Spine, Thoracic, Urology, Vascular 11104 Punch biopsy of skin (including simple closure, when General, Aesthetics, performed); single lesion Cardiovascular, Colorectal, ENT, Maxillofacial, Plastics, Orthopedics, Spine, Thoracic, Urology, Vascular 11106 Incisional biopsy of skin (eg, wedge) (including simple closure, General, Aesthetics, when performed); single lesion Cardiovascular, Colorectal, ENT, Maxillofacial, Plastics, Orthopedics, Spine, Thoracic, Urology, Vascular 17000 Destruction (eg, laser surgery, electrosurgery, cryosurgery, General, Aesthetics, chemosurgery, surgical curettement), premalignant lesions (eg, Cardiovascular, Colorectal, actinic keratoses); first lesion ENT, Maxillofacial, Plastics, Orthopedics, Spine, Thoracic, Urology, Vascular BIOPSY OR EXCISION, LESION, LOWER BODY EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) LOWER BODY General, Gynecology, Orthopedics, Plastics, Urology, Neurosurgery, Aesthetics, Colorectal, Spine, Vascular, Podiatry BIOPSY OR EXCISION, LESION, LOWER BODY, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE LOWER BODY 11102 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, single lesion Orthopedics, Plastics, Urology, Aesthetics, Vascular, Maxillofacial, Thoracic, Cardiovascular, ENT, Colorectal, Podiatry 11103 Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); General, Gynecology, each separate/additional lesion (list separately in addition to Orthopedics, Plastics, Urology, code for primary procedure) Aesthetics, Vascular, Maxillofacial, Thoracic, Cardiovascular, ENT, Colorectal, Podiatry Page 3 of 38 * Indicates Inpatient only CPT Code/Procedure SJH Procedures - General Service New Name Old Name CPT Code Service BIOPSY OR EXCISION, LESION, LOWER BODY, 2 OR MORE EXCISE/BIOPSY (MASS/LESION/LIPOMA/CYST) MULTIPLE LOWER BODY 11104 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); single lesion Orthopedics, Plastics, Urology, Aesthetics, Vascular, Maxillofacial, Thoracic, Cardiovascular, ENT, Colorectal, Podiatry 11105 Punch biopsy of skin (including simple closure, when General, Gynecology, performed); each separate/additional lesion (list separately in Orthopedics, Plastics, Urology, addition to code for primary procedure) Aesthetics, Vascular, Maxillofacial, Thoracic, Cardiovascular, ENT, Colorectal,
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