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Medicare Program; Update of Ambulatory Surgical Center List of Covered Procedures Effective July 1, 2003

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AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Final rule with comment period.

SUMMARY:

This final rule with comment period will make additions to and deletions from the current list of Medicare approved ambulatory surgical center (ASCs) procedures. In addition, it responds to comments received on the June 12, 1998 proposed rule (63 FR 32290) that addressed proposed additions to and deletions from the list of ASC covered procedures. This rule also implements requirements of section 1833(i)(1) and (2) of the Social Security Act.

DATES:

Effective date: These regulations are effective for services furnished on or after July 1, 2003.

Comment date: We will consider comments on new proposed additions to and deletions from the ASC list of covered procedures if we receive them at the appropriate address, as provided below, no later than May 27, 2003.

ADDRESSES:

Mail written comments (1 original and 2 copies) to the following address: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1885-FC, P.O. Box 8013, Baltimore, MD 21244-8013.

To insure that mailed comments are received in time for us to consider them, please allow for possible delays in delivering them.

Because of staff and resource limitations, we cannot accept comments by facsimile (FAX) transmission. In commenting, please refer to file code CMS-1885-FC.

If you prefer, you may deliver (by hand or courier) your written comments (1 original and 2 copies) to one of the following addresses: Room 445-G, Hubert H. Humphrey Building, 200 Independence Avenue, SW., Washington, DC 20201 or Room C5-14-03, 7500 Security Boulevard, Baltimore, MD 21244-8013.

(Because access to the interior of the HHH Building is not readily available to persons without Federal Government identification, commenters are encouraged to leave their comments in the CMS drop slots located in the main lobby of the building. A stamp-in clock is available for commenters wishing to retain a proof of filing by stamping in and retaining an extra copy of the comments being filed.)

Comments mailed to the addresses indicated as appropriate for hand or courier delivery may be delayed and could be considered late.

For information on viewing public comments, see the beginning of the SUPPLEMENTARY INFORMATION section.

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FOR FURTHER INFORMATION CONTACT:

Bob Cereghino, 410-786-4675.

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SUPPLEMENTARY INFORMATION:

Inspection of Public Comments

Comments received timely will be available for public inspection as they are received, generally beginning approximately 2 weeks after the close of the comment period, at the headquarters of the Centers for Medicare and Medicaid Services, 7500 Security Boulevard, Baltimore, Maryland 21244, Monday through Friday of each week from 8:30 a.m. to 5 p.m. To schedule an appointment to view public comments, please call (410) 786-7197.

Copies

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This Federal Register document is also available from the Federal Register online database through GPO access, a service of the U.S. Government Printing Office. The Web site address is http://www.access.gpo.gov/​nara/​index.html.

I. Background

A. Legislative History

Specific provisions of the proposed rule are discussed in detail in Section II below.

Section 1832(a)(2)(F)(i) of the Social Security Act (the Act) provides that benefits under the Medicare Supplementary Medical Insurance program (Part B) include payment for facility services furnished in connection with surgical procedures we specify and which are performed in an ambulatory surgical center (ASC). We are to review and update the list of ASC procedures biennially. To participate in the Medicare program as an ASC, a facility must meet the standards specified under section 1832(a)(2)(F)(i) of the Act and 42 CFR 416.25, which sets forth general conditions and requirements for ASCs.

Generally, there are two primary elements in the total cost of performing a surgical procedure—the cost of the physician's professional services for performing the procedure and the cost of services furnished by the facility where the procedure is performed (for example, surgical supplies and equipment and nursing services). Section 1833(i)(2)(A) of the Act addresses what the ASC facility fee is intended to represent and how the amount of the Medicare payment for ASC facility services is to be determined. It requires us to review and update ASC payment amounts annually.

The ASC payment rate is to be a standard overhead amount established on the basis of our estimate of a fair fee that takes into account the costs incurred by ASCs generally in providing facility services in connection with performing a specific procedure. The Report of the Conference Committee accompanying section 934 of the Omnibus Budget Reconciliation Act of 1980 (Pub. L. 96-499), which enacted the ASC benefit in December 1980, states that this overhead factor is expected to be calculated on a prospective basis using sample survey and similar techniques to establish reasonable estimated overhead allowances, which take account of volume (within reasonable limits), for each of the listed procedures. (See H.R. Rep. No. 1479, at 134 (1980).) To estimate the amount of those reasonable allowances, we are required by section 1833(i)(2)(A)(i) of the Act to survey the actual audited costs incurred by a representative sample of facilities in connection with a representative sample of procedures. Because payment for ASC facility services is subject to the usual Medicare Part B deductible and coinsurance requirements, Medicare pays participating ASCs 80 percent of the prospectively-determined rate, adjusted for regional wage variations. Section 1833(i)(2)(A)(ii) of the Act requires that the ASC payment rates result in substantially lower Medicare Start Printed Page 15269expenditures than would have been paid if the same procedure had been performed on an inpatient basis in a hospital. Section 1833(i)(2)(A)(iii) of the Act requires that payment for insertion of an intraocular lens (IOL) include an allowance for the IOL that is reasonable and related to the cost of acquiring the class of lens involved.

Section 13531 of the Omnibus Budget Reconciliation Act of 1993 (OBRA 1993) (Pub. L. 103-66), prohibited us from providing for any inflation update in the payment amounts for ASCs determined under section 1833(i)(2)(A) of the Act for fiscal years (FYs) 1994 and 1995. Section 13533 of OBRA 1993 established $150 as the amount of payment allowed for an IOL inserted during or subsequent to cataract surgery in an ASC on or after January 1, 1994, and before January 1, 1999. Section 141(a)(1) of the Social Security Act Amendments of 1994 (SSAA 1994) (Public Law 103-432) amended section 1833(i)(2)(A)(i) of the Act to require that a quinquennial survey of ASCs be taken beginning not later than January 1, 1995.

Section 141(a)(2) of SSAA 1994 added section 1833(i)(2)(C) to the Act to provide that, beginning with FY 1996, there be an adjustment for inflation during fiscal years when we do not update ASC rates based on actual audited costs determined by surveying a representative sample of facilities. Section 1833(i)(2)(C) of the Act provides that ASC payment rates are to be increased by the percentage increase in the consumer price index for urban consumers (CPI-U), that we estimate for the 12-month period ending with the midpoint of the year involved, beginning with FY 1996. Section 141(a)(3) of SSAA 1994 amended section 1833(i)(1) of the Act to require us to consult with appropriate medical organizations in specifying the procedures that constitute the ASC list.

Section 141(b) of SSAA 1994 requires us to establish a process for reviewing the appropriateness of the payment amount provided under section 1833(i)(2)(A)(iii) of the Act for IOLs with respect to a class of new-technology IOLs. That process was the subject of a separate notice of proposed rulemaking entitled Adjustment in Payment Amounts for New Technology Intraocular Lenses published in the Federal Register on September 9, 1997 (62 FR 46698).

Section 4555 of BBA 1997 amended section 1833(i)(2)(C) of the Act to limit the annual adjustment of ASC payment rates provided for in that paragraph to the CPI-U increase reduced by 2.0 percentage points (but not below zero) for fiscal years 1998 through 2002.

B. Extensions of Comment Periods for Proposed Rule

On June 12, 1998, we published in the Federal Register a proposed rule that would revise the ratesetting methodology and payment rates and update the list of surgical procedures payable by Medicare for ASCs. The closing date of the comment period for the June 12, 1998 proposed rule was extended several times. The first extension notice was published in the Federal Register August 14, 1998 (63 FR 43655). The reason for the extension was that, due to the complexity and scope of the proposed rule, numerous members of the industry and professional associations requested more time to analyze the potential consequences of the rule. The closing date was extended to September 10, 1998.

On September 8, 1998, a proposed rule outlining the provisions of a Medicare prospective payment system (PPS) for hospital outpatient services was published in the Federal Register (63 FR 47551). On October 1, 1998 a second extension notice extending the comment period for the June 12, 1998 proposed rule was published in the Federal Register (63 FR 52663) with a new closing date of November 9, 1998. This second extension notice was issued because members of trade and professional associations urged us to postpone implementing the changes contained in the June 12, 1998 ASC proposed rule from October 1, 1998 to January 1, 1999 to coincide with implementation of the OPPS. They based their argument for delaying implementation of the ASC changes both on the need for more time for cross-analysis of the ASC proposed rule with the hospital outpatient prospective payment system (OPPS) proposed rule and the overlap and interrelationship between the two payment systems. This second extension notice also explained that there would be no inflationary update of the ASC rates on October 1, 1998 because reducing the fiscal year CPI-U factor of 2.1 percent by 2.0 percent would result in a change of less than $1 for each payment group.

A third notice, which extended the comment period to January 8, 1999, was published in the Federal Register on November 15, 1998. This extension was necessary because the OPPS proposed rule comment period was being extended and Medicare payments to ASCs were closely linked to the way Medicare proposed to pay hospitals under the OPPS. A fourth extension notice was published in the Federal Register on January 12, 1999 (64 FR 1785). The reason given was the same as the prior extension notice, that is, because the comment period for the OPPS rule was being extended for further examination and because the two proposed payment systems were closely related. The new closing date of March 9, 1999 would run concurrently with the OPPS extension. On March 2, 1999, a fifth extension notice with the same rationale as the fourth notice was published in the Federal Register (64 FR 12278) and extended the comment period for an additional 60 days.

The sixth and final extension was published in the Federal Register July 6, 1999 (64 FR 36321). On June 30, 1999 we published a correction notice (64 FR 35258) in the Federal Register that corrected a number of technical and typographical errors contained in the September 8, 1998 OPPS proposed rule. To provide commenters adequate time to analyze the potential impact of the corrections to the OPPS proposed rule on ASC payments and because of the link between Medicare ASC payments and hospital outpatient payments, we found it appropriate to extend the comment period for the ASC proposed rule to July 30, 1999.

II. Provisions of the Proposed Regulations

In the June 12, 1998, proposed rule, we proposed the following:

  • Clarification of the definition of ASC.
  • Revision of the basic requirements in § 416.3 and § 416.4.
  • Additions to and deletions from the ASC list.
  • Revision of the criteria for determining surgical procedures payable in an ASC in § 416.65 and elimination of numeric thresholds.
  • Establishment of an ASC Advisory Group.
  • Replacement of eight ASC payment groups with ambulatory payment classification (APC) groups that are clinically homogeneous and consist of procedures with similar resource inputs, modeled on the APC groups proposed for the OPPS.
  • Redefinition of the ASC ratesetting methodology.
  • Rebased payment rates to reflect a survey of ASC costs that was conducted in 1994.

A combination of circumstances has resulted in our delaying publication of a final rule to implement the changes proposed in the June 12, 1998 ASC proposed rule. First, as discussed above, we extended the public comment period to July 30, 1999 in response to requests from the industry to allow adequate opportunity for comparison of the Start Printed Page 15270proposed ASC rates and ratesetting methodology with the proposed OPPS that was published in the Federal Register on September 8, 1998, followed by publication of an OPPS correction notice on June 30, 1999. Notwithstanding the close of the comment period on July 30, 1999, the changes required to implement a new payment system for ASC facility services could not be implemented because our contractors had to prepare Medicare claims processing systems to be Year 2000 (“Y2K”) compliant.

On November 29, 1999, the Balanced Budget Refinement Act of 1999 (BBRA)(Pub. L. 106-113) was enacted. Section 226 of BBRA required that full implementation of the proposed ASC rates be delayed over a 3 year period. Specifically, the BBRA stated that if a prospective payment system for ASCs, that is, one involving the June 1998 proposed rates, was implemented prior to incorporating data from a 1999 or subsequent Medicare cost survey, in the first year of implementation no more than 1/3 of the new ASC payment would consist of this new rate and the remainder would consist of the current payment rate. In the following year, no more than 2/3 of the new rate would consist of the June 1998 proposed rate and the remainder would consist of the current rate.

Significant changes in the OPPS were also required as a result of the enactment of the BBRA. Substantial pressures to implement the OPPS combined with the new OPPS requirements resulting from enactment of the BBRA compelled us to focus all available resources on the OPPS, which was implemented on August 1, 2000.

On December 21, 2000, the Medicare, Medicaid and SCHIP Benefit Improvement and Protection Act of 2000 (BIPA)(Pub. L. 106-554) was enacted. Section 424 of BIPA prohibited implementation of a revised prospective payment system for ASC facility services before January 1, 2002, extended the phase-in of the APC system for ASCs to four years and required that by January 1, 2003, ASC rates be rebased using data from a 1999 or later Medicare survey.

The changes mandated by the BBRA and the BIPA, combined with the diversion of resources necessitated by Y2K compliance activities and implementation and start-up issues related to the OPPS have resulted in the delay in issuing a final ASC rule to implement the changes in the June 12, 1998 proposed rule. As stated above, Section 424 of BIPA requires that payment rates effective January 1, 2003 be based on a survey of ASCs conducted after 1999. We have developed an ASC survey instrument, but our experience in collecting ASC cost data in 1994 suggests that completion of the survey instrument, followed by an audit of the data reported by ASCs and the subsequent compilation of cost data upon which to base ASC payment rates, takes at least 2 years. Therefore, rather than delaying further the biennial update of the ASC list mandated by the statute, in this final rule with comment period we are making final only the additions to and deletions from the ASC list that we proposed in the June 12, 1998 proposed rule. We are not implementing at this time any of the other changes proposed in the June 1998 proposed rule. That is, we are not making final the regulatory changes in part 416 that we proposed or the proposed ratesetting methodology based on APC groups and survey data of ASC costs collected in 1994. We recognize that we are not in compliance with the requirements enacted by section 424 of BIPA, that we rebase rates by January 1, 2003 using data from a survey of ASC costs taken in 1999 or later. While we are committed to rebasing and restructuring the ASC payment rates, we are also committed to ensuring that the method we use to rebase ASC payment rates does not inadvertently result in rates that amplify payment differentials across ambulatory sites of service. We are studying approaches to ratesetting, some of which may require legislative change that will provide adequate payments to ASCs for surgical services and that are in line with what Medicare pays under the OPPS and the physician fee schedule for the same service.

In section III of this preamble, we respond to comments that we received timely on our proposed additions to and deletions from the ASC list. In addition, we are proposing to add to the list a limited number of new CPT codes that were added to CPT in 1999, 2000, 2001, 2002, and 2003 and that are similar to procedures on the updated ASC list. These new CPT codes are designated by an “A*” in column 2 of the Addendum. We solicit comments on the addition of these new CPT codes and the payment rates proposed for these new codes.

In the June 1998 proposed rule, we listed codes with corresponding new payment rates based on the 1994 survey of ASC costs. Because we do not have current survey data upon which to base new payment rates, we have assigned the codes being added to the ASC list in this final rule to one of the nine existing payment groups under which payments for ASC facility services are currently made. With the guidance of our medical advisors, we matched additions to the ASC list with codes for procedures already on the ASC list that they most closely resemble in terms of clinical work and resource inputs such as equipment, supplies, and time required in the operating suite. We assigned the additions to the list to the same payment group to which the matching codes are currently assigned. For example, our medical advisors determined that CPT code 24341, Repair tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff), is in the same family of codes as CPT code 24340, Tenodesis of biceps tendon at elbow (separate procedure) and CPT code 24342, Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft. CPT codes 24340 and 24342 are both currently assigned to payment group 3. Because the resource inputs such as supplies, equipment, and time in the operating suite for CPT code 24341 are similar to the resources required to perform CPT codes 24340 and 24342, we assigned CPT code 24341 to group 3 to maintain consistency in payment for this family of closely related codes.

In the case of some codes, such as CPT 47511, Introduction of percutaneous transhepatic stent for biliary drainage, we identified procedures on the current list that they most closely resemble clinically and in terms of resource inputs, but we assigned the code to a higher payment group to take into account expensive equipment or supplies that are required to perform the procedure. Therefore, while CPT code 47511 is similar to CPT code 47510, which is currently on the ASC list and assigned to payment group 2, we assigned CPT code 47511 to payment group 9 to take into account the added cost of expensive supplies required for this procedure.

There are some procedures that we proposed to add to the ASC list in the June 1998 proposed rule that we are not adding to the list at this time. We are not adding to the ASC list procedures that are inconsistent with our current criteria in § 416.65 for determining surgical procedures payable in an ASC. Also, we are not adding to the list procedures that would otherwise have met the criteria for inclusion on the ASC list, except that they would be significantly overpaid in the lowest ASC payment group, which could create an incentive to shift these procedures to an ASC setting. The payment rates proposed for many of these procedures in the June 12, 1998 proposed rule were significantly less than the lowest current ASC payment group because we were proposing a different ratesetting method Start Printed Page 15271using APC groups. We are also eliminating proposed additions to the ASC list that were deleted from CPT after 1998, and there are some codes that we proposed to add but are not adding on the basis of comments. The codes that we are not adding to the ASC list for these reasons are listed in the following table. We recognize that most of the additions and deletions to the ASC list that are being implemented through this final rule were proposed nearly 5 years ago. Our medical advisors have reviewed all of the changes reflected in this final rule and we believe that, taking patient safety into account , the final updated list reasonably reflects contemporary surgery performed in an ASC in the year 2003.

Procedures Proposed for Addition to the ASC List That Are Not Being Added

HCPCSShort descriptor
11752Remove nail bed/finger tip.
11760Repair of nail bed.
11762Reconstruction of nail bed.
11920Correct skin color defects.
11921Correct skin color defects.
11922Correct skin color defects.
11950Therapy for contour defects.
11951Therapy for contour defects.
11952Therapy for contour defects.
11954Therapy for contour defects.
12001Repair superficial wound(s).
12002Repair superficial wound(s).
12004Repair superficial wound(s).
12011Repair superficial wound(s).
12013Repair superficial wound(s).
12014Repair superficial wound(s).
12015Repair superficial wound(s).
12031Layer closure of wound(s).
12032Layer closure of wound(s).
12041Layer closure of wound(s).
12042Layer closure of wound(s).
12051Layer closure of wound(s).
12052Layer closure of wound(s).
12053Layer closure of wound(s).
15819Plastic surgery, neck.
15836Excise excessive skin tissue.
15837Excise excessive skin tissue.
15838Excise excessive skin tissue.
15839Excise excessive skin tissue.
15860Test for blood flow in graft.
16010Treatment of burn(s).
16040Deleted by CPT.
16041Deleted by CPT.
16042Deleted by CPT.
17106Destruction of skin lesions.
17107Destruction of skin lesions.
17108Destruction of skin lesions.
17304Chemosurgery of skin lesion.
173052nd stage chemosurgery.
173063rd stage chemosurgery.
17307Followup skin lesion therapy.
17310Extensive skin chemosurgery.
19396Design custom breast implant.
21030Removal of face bone lesion.
21031Remove exostosis, mandible.
21032Remove exostosis, maxilla.
21110Interdental fixation.
21120Reconstruction of chin.
21125Augmentation, lower jaw bone.
21260Revise eye sockets.
20500Injection of sinus tract.
20950Fluid pressure, muscle.
24640Treat elbow dislocation.
24650Treat radius fracture.
25500Treat fracture of radius.
25530Treat fracture of ulna.
25560Treat fracture radius & ulna.
25600Treat fracture radius/ulna.
25622Treat wrist bone fracture.
25630Treat wrist bone fracture.
25650Treat wrist bone fracture.
26600Treat metacarpal fracture.
26641Treat thumb dislocation.
26670Treat hand dislocation.
26700Treat knuckle dislocation.
26720Treat finger fracture, each.
26725Treat finger fracture, each.
26740Treat finger fracture, each.
26750Treat finger fracture, each.
26755Treat finger fracture, each.
26770Treat finger dislocation.
26775Treat finger dislocation.
27200Treat tail bone fracture.
27220Treat hip socket fracture.
27256Treat hip dislocation.
27556Treat knee dislocation.
28001Drainage of bursa of foot.
28010Incision of toe tendon.
28108Removal of toe lesions.
28124Partial removal of toe.
28220Release of foot tendon.
28230Incision of foot tendon(s).
28232Incision of toe tendon.
28272Release of toe joint, each.
28360Reconstruct cleft foot.
28430Treatment of ankle fracture.
28450Treat midfoot fracture, each.
28455Treat midfoot fracture, each.
28470Treat metatarsal fracture.
28475Treat metatarsal fracture.
28490Treat big toe fracture.
28495Treat big toe fracture.
28510Treatment of toe fracture.
28515Treatment of toe fracture.
28530Treat sesamoid bone fracture.
28540Treat foot dislocation.
28570Treat foot dislocation.
28600Treat foot dislocation.
28630Treat toe dislocation.
28660Treat toe dislocation.
30901Control of nosebleed.
31040Exploration behind upper jaw.
31502Change of windpipe airway.
31520Diagnostic laryngoscopy.
32960Therapeutic pneumothorax.
36493Repositioning of cvc.
37618Ligation of extremity artery.
40702Repair cleft lip/nasal.
40830Repair mouth laceration.
41822Excision of gum lesion.
41823Excision of gum lesion
42227Lengthening of palate.
42326Create salivary cyst drain.
42400Biopsy of salivary gland
42800Biopsy of throat.
42842Extensive surgery of throat
42844Extensive surgery of throat.
42970Control nose/throat bleeding
43020Incision of esophagus
43030Throat muscle surgery
43761Reposition gastrostomy tube.
45300Proctosigmoidoscopy dx.
45303Proctosigmoidoscopy dilate.
45330Diagnostic sigmoidoscopy
46604Anoscopy and dilation.
46614Anoscopy/control bleeding.
46900Destruction, anal lesion(s).
46910Destruction, anal lesion(s).
46916Cryosurgery, anal lesion(s).
49429Removal of shunt.
50590Lithotripsy.
51705Change of bladder tube
52265Cystoscopy and treatment
52301Cystoscopy and treatment
52339Deleted by CPT.
53025Incision of urethra.
53060Drainage of urethra abscess.
53852Prostatic rf thermotx.
54050Destruction, penis lesion(s).
54055Destruction, penis lesion(s).
54056Cryosurgery, penis lesion(s).
54402Deleted by CPT.
54407Deleted by CPT.
54409Deleted by CPT.
55450Ligation of sperm duct.
56311Deleted by CPT.
56312Deleted by CPT.
56313Deleted by CPT.
56314Deleted by CPT.
56318Deleted by CPT.
56320Deleted by CPT.
56346Deleted by CPT.
56353Deleted by CPT.
56355Deleted by CPT.
56501Destroy, vulva lesions, simp.
57284Repair paravaginal defect.
57288Repair bladder defect.
57460Cervix excision.
57555Remove cervix/repair vagina.
58345Reopen fallopian tube.
58970Retrieval of oocyte
59300Episiotomy or vaginal repair.
60100Biopsy of thyroid.
60210Partial thyroid excision.
60240Removal of thyroid
61000Remove cranial cavity fluid.
61001Remove cranial cavity fluid.
62292Injection into disk lesion.
62298Deleted by CPT
63615Remove lesion of spinal cord.
64555Implant neuroelectrodes.
64560Implant neuroelectrodes.
64565Implant neuroelectrodes.
64761Incision of pelvis nerve.
65286Repair of eye wound.
65450Treatment of corneal lesion.
65820Relieve inner eye pressure.
65855Laser surgery of eye.
65860Incise inner eye adhesions.
66761Revision of iris.
66762Revision of iris.
66770Removal of inner eye lesion.
66820Incision, secondary cataract.
67101Repair detached retina
67110Repair detached retina.
67208Treatment of retinal lesion.
Start Printed Page 15272
67343Release eye tissue.
68100Biopsy of eyelid lining.
68110Remove eyelid lining lesion.
68135Remove eyelid lining lesion.
69433Create eardrum opening.

We are not adding to the ASC list CPT code 50590 Extracorporeal Shock Wave Lithotripsy (ESWL), for which we had proposed a payment of $2107 in the June 1998 proposed rule. In American Lithotripsy Society v. Sullivan, 785, F. Supp. 1035 (D.D.C. 1992), the District Court ordered that we “publish the data and other information we are relying on in setting a (lithotripsy) rate and allow time for comment before issuing a final notice * * *”. The data and other information that we would rely on in setting a payment rate for ESWL are part of the ratesetting methodology that we proposed in the June 1998 proposed rule. Because we are not making that ratesetting methodology final at this time, we might not be in compliance with the District Court order if we were to add CPT code 50590 to the ASC list in this final rule under the current payment rate structure. In addition, comments submitted by the American Lithotripsy Society opposed the $2,107 payment rate that we proposed in the June 1998 proposed rule. Therefore, we are not including CPT code 50590 among the additions to the ASC list that are implemented by this final rule.

III. Analysis of and Responses to Public Comments

In response to the publication of the June 12, 1998 proposed rule, we received approximately 13,000 comments, many of which were duplicate comments that were resubmitted each time we extended the comment period. We received comments from individual ASCs, physicians, health care workers, professional and trade associations, and medical societies and organizations. The majority of the comments addressed our proposal to adopt ambulatory payment classification (APC) groups as the basis for setting ASC payment rates. In addition, we received numerous comments regarding our proposal to package payment for corneal tissue into the payment rate for corneal transplant surgery. We also received numerous comments regarding proposed reductions in payment for gastroenterological procedures. Those comments will be addressed in a subsequent rule when we implement changes in the ASC ratesetting methodology. In this final rule with comment, we only respond to comments that address additions to and deletions from the list of approved procedures.

Overall, the commenters who addressed our proposed additions to and deletions from the ASC list favored the proposed additions. Most commenters supported expansion of the ASC list to the maximum possible extent to permit Medicare payment to ASCs for procedures that are performed on an outpatient basis in hospitals. We respond below to commenters who recommended the addition or deletion of specific CPT codes. In reviewing the comments regarding our proposed additions to and deletions from the ASC list, we consulted our medical advisors, and we took into account Congressional intent when the ASC benefit was enacted as well as the current standards for the ASC list that are codified in § 416.65.

As we explain above, we do not include in the list of ASC approved procedures, procedures currently performed on an ambulatory basis in a physician's office that do not generally require the more elaborate facilities of an ASC. Also, the ASC list does not include procedures that are appropriately performed in an inpatient hospital setting but would not be safely performed in an ASC, consistent with the criteria in § 416.65(b)(3).

We also recognized that there are some procedures that might be appropriately performed in ASC for the younger patient who is generally healthy. But for the larger number of beneficiaries whose health is more likely to be compromised by age or disability, an ASC may be a questionable setting for those same procedures. Therefore, we are adding to the ASC list only those procedures that can be safely performed in an ASC on the general Medicare population in at least a significant number of cases.

We believe that the ASC list resulting from the additions and deletions that we are implementing in this final rule with comment is an improvement over the existing list. We have updated the ASC list by adding a significant number of the procedures that we proposed to add in the June 1998 proposed rule as well as new CPT codes established since 1998 that are consistent with our criteria for the ASC list. The resulting updated list allows ASCs to furnish to Medicare beneficiaries surgical services that reflect the practice of contemporary surgery without compromising patient safety. We will continue to update the list through notice and comment within the biennial timeframe established under the statute. As part of the next biennial update, we will also consider proposing revised criteria to apply in determining which procedures are appropriate for the ASC list.

Comment: A number of commenters favored elimination of the ASC list. The commenters stated that the decision regarding where to perform a procedure should rest with the physician and the patient, not with CMS.

Response: Section 1833(i)(1) of the Act requires us to determine which surgical procedures are safely and appropriately performed in an ASC. Therefore, we cannot adopt this recommendation.

Comment: A national medical association commented that we should not add certain codes that we proposed to add because these procedures are hospital procedures and are not appropriate for same day surgery in an ASC. These procedures are CPT codes 57284 (paravaginal defect repair), 57288 (stress incontinence), 57555 (cervical stump excision), 58345 (fallopian tube catheter), and 57460 (colposcopy).

Response: After a review of our most recent claims data for site of service and an examination of the clinical nature of the surgical procedures in question, we agree with the commenter, and we are not adding these codes to the list.

Comment: The same commenter agreed with our proposal to add CPT codes 57291 (artificial vagina construction) and 57556 (cervical stump excision) to the ASC list and our proposal to delete CPT codes 56405 (vulva drainage) and 57800 (cervix dilation) from the ASC list.

Response: We agree with the commenter. We are adding CPT codes 57291 and 57556 to the ASC list and deleting CPT codes 56405 and 57800.

Comment: A medical specialty society commented that we should delete from the ASC list CPT codes 15842 (microsurgical muscle graft), 26035 (decompression fingers, injection injury), 26037 (decompressive fasciotomy, hand), 27440 (arthroplasty, knee, tibial plateau), 42225 (palatoplasty w. attached pharyngeal flap), 60220 (total thyroid lobectomy), and 60225 (total thyroid lobectomy). The commenter states that these procedures are hospital procedures and not appropriate for an ASC.

Response: We agree with the commenter and we are deleting these 7 procedures from the current list.

Comment: The same commenter disagreed with our proposal to add to the list the following procedures: CPT codes 42842 (extensive throat surgery), 42844 (extensive throat surgery), 57284 Start Printed Page 15273(paravaginal defect repair), 60210 (thyroid partial excision), and 60240 (thyroid removal). The commenter stated that these procedures are hospital procedures and not appropriate for same day surgery performance in an ASC. Another medical organization also recommended not adding CPT code 57284 to the list.

Response: Our medical staff have reviewed these codes and agree with the commenters. Therefore, we are not implementing these proposed additions to the list.

Comment: The same medical specialty society further stated that the following codes should be deleted from the ASC list: 15840 (face nerve palsy graft), 15841 (face nerve palsy graft), 15845 (skin and muscle repair, face), 19318 (large breast reduction), and 19340 (immediate breast prosthesis). The commenter stated these procedures are not appropriate for an ASC setting.

Response: Our medical staff have reviewed the clinical nature of these procedures and have determined that they may appropriately be performed in an ASC. Further, our 2001 claims data show that these procedures are being performed in a significant number of cases in an outpatient setting. Therefore, we are retaining these procedures on the ASC list.

Comment: The same commenter states that we should not add proposed CPT code 40700 (repair cleft lip, nasal), because this procedure is not appropriate for an ASC.

Response: Our 2001 claims data indicate that equal numbers of cases were reported as being performed in a hospital inpatient, hospital outpatient, and ASC setting. Our medical advisors reviewed the clinical nature of this procedure and determined that it is appropriately performed in an ASC setting. Therefore, we will add this code to the list.

Comment: Commenters suggested that we add to the ASC list the following CPT codes: 27096 (injection, sacroiliac joint), 62284 (myelography, injection), 62287 (Aspiration/decompression, nucleus pulposus), 62290 (discography injection, lumbar), 62291 (discography injection, cervical), 62292 (chemonucleolysis injection), 62298 (injection, other than anesthetic), 64640 (destruction by neurolytic agent, peripheral nerve), and 64714 (neuroplasty).

Response: Our medical staff reviewed the clinical nature of these codes and agreed that CPT codes 27096, 62292, and 62298 were appropriate additions to the ASC list. Note that in CY 2000, CPT code 62298 was replaced by code 62310, which we added to the ASC list in 2000 by program memorandum. CPT codes 27096 and 62292, while clinically appropriate for the list, would be significantly overpaid in the lowest ASC payment group, so we are not adding them to the ASC list. CPT code 64714 is already on the ASC list. CPT codes 62284, 62290 and 62291 are codes for injections used in connection with diagnostic imaging procedures that are not payable as ASC services. Therefore, we would not pay separately for these procedures in the ASC setting. According to our Medicare billing data, CPT 64640 is performed 68 percent of the time in a physician's office, so this procedure is not being added to the list. CPT 62287, which we proposed for addition to the list, will be added.

Comment: Some commenters believed that it was appropriate to add CPT codes 42415 (parotoid surgery), 31254 (partial ethmoid endoscopy), 31255 (ethmoid endoscopy), 31256 (nasal endoscopy with antrostomy), 31267 (nasal endoscopy with maxillary endoscopy), and 31276 (nasal endoscopy with frontal endoscopy) to the list. The commenters asserted that all of these procedures are suitable and routinely performed in an ASC setting.

Response: After review by clinical staff, we agree with the commenter and we are adding CPT code 42415 to the list. CPT codes 31254, 31255, 31256, 31267 and 31276 are currently on the ASC list and will remain on the list.

Comment: We received comments stating that certain laproscopic procedures should be added to the ASC list. They are: CPT codes 56340, 56341 and 56342 (laparoscopic cholecystectomy with and without cholangiography and common duct exploration) and CPT code 56348 (laparoscopic assisted vaginal hysterectomy). Commenters stated these procedures are routinely performed in an outpatient setting and would be appropriate for an ASC.

Response: Our medical staff determined that these procedures may be appropriately performed in an ASC for many non-Medicare beneficiaries in the 65-and-under age group. However, these procedures often involve an overnight stay for Medicare beneficiaries and they do not conform to our standard for ASC procedures in § 416.65(b)(ii). Therefore, we are not adding them to the ASC list.

Comment: Some commenters wrote that we should retain the following procedures proposed for deletion: CPT codes 51726 (Complex cystometrogram), 51772 (Urethra pressure profile), 51785 (Anal/urinary pressure study), 50392 (Insert kidney drain), 50393 (Insert ureteral tube), 50395 (Create passage for kidney), 50684 (Injection for ureter x-ray), 50690 (Injection for ureter x-ray), 51600 (Injection for bladder x-ray), 51605 (Preparation for bladder x-ray), and 51610 (Injection for bladder x-ray).

Response: Our medical staff reviewed these codes in light of the commenters' arguments against deleting them, and we agree that CPT codes 51726, 51772, 51785, 50392, 50393, and 50395 should be retained on the ASC list. CPT codes 50684, 50690, 51600, 51605, and 51610 are services that involve injections, which are packaged into imaging procedures that are not payable in an ASC, and we are making final their deletion from the ASC list.

Comment: Some of the same commenters also agreed with our proposal to delete CPT code 51725, Simple Cystometrogram and not add to the list CPT codes 51736 Simple Uroflowmetry and 51741 Complex Uroflowmetry.

Response: In the absence of disagreement from commenters, we are making our proposal regarding these codes final.

Comment: Another commenter recommended that we not remove the following CPT codes from the list: 50970, 50972, 50974, 50976, 50978, and 50980, all of which are ureteral endoscopy codes.

Response: We reviewed these procedures and we agree with the commenter that they are appropriate to the ASC setting and consistent with our criteria for the ASC list. Therefore, we are not removing these codes from the list.

Comment: A few commenters wanted us not to delete CPT codes 51005 (Aspiration of bladder) and 51010 (Aspiration of bladder). These commenters also wanted us to add the following codes to the ASC list: 54450 (Foreskin manipulation), 51000 (Aspiration bladder), 53600 (Dilate urethral stricture), 53601 (Dilate urethral stricture), 53621 (Dilate urethral stricture), 53660 (Dilation female urethra), 53661 (Subsequent dilation female urethra), 53675 (Catheterization, complicated), and 54200 (Injection procedure, Peyronie).

Response: We reviewed our utilization data and agree with the commenters that CPT code 51010 should remain on the ASC list. With the exception of CPT code 53675, all of the other procedures recommended by the commenters are performed more than 50 percent of the time in physicians' offices, some as frequently as 99 percent of the reported cases. Therefore, we are not adding these procedures to the list consistent with our current regulation at § 416.65(a)(2), which requires that the Start Printed Page 15274ASC list not include procedures that are commonly performed or that may be safely performed in physicians' offices. CPT code 53675, Complex catheterization, would be significantly overpaid in the lowest ASC payment group. Therefore, we are not adding this procedure to the list.

Comment: A few commenters opposed our proposal to remove the following codes from the ASC list: CPT codes 50520 (Closure of nephrocutaneous fistula), 50570 (Renal endoscopy), 50572 (Renal endoscopy), 50574 (Renal endoscopy), 50576 (Renal endoscopy), 50578 (Renal endoscopy), and 50580 (Renal endoscopy).

Response: These codes describe procedures that are not consistent with our criteria in section § 416.65(b)(3) and therefore are not appropriate to be performed in an ASC. Therefore, we are making our proposal final and we are deleting these codes from the list.

Comment: In our proposed rule we proposed to delete the following nerve injection CPT codes: 64410, 64415, 64417, 64420, 64421, 64430, 64442, 64443, 64510, 64520, 64530, 64600, 64605, 64610, 64620, 64622, 64623, 64630, and 64680. These proposed deletions prompted numerous comments from ASCs specializing in pain management and from interventional pain physicians. Commenters argued that concerns about patient safety supported retaining these nerve block injection codes on the ASC list. They stated that the minimally acceptable requirements for safe completion of these procedures include continuous monitoring of heart function, lung function and breathing. The placement of injections in the spinal area requires the highest infection control standards. In addition, fluoroscopic guidance is necessary to assure precise needle placement. Injections can provoke severe hypertension, chest pain, cardiac arrythmias, myocardial infarction, severe pain and vasovagal reactions. Risks include seizures, respiratory and cardiac arrest, hypotension, respiratory depression, pneumothorax, total spinal anesthesia, infection, local anesthetic toxicity, paralysis and death. Commenters argued that because of the risks associated with these procedures, they require the health and safety protections assured by the conditions for coverage of ASC services found in part 416 of the regulations.

A few commenters supported deletion of the nerve injection codes from the ASC list. These commenters stated that they are able to perform these nerve injections in their offices. However, these commenters also stated that they operate in environments with resuscitation facilities and radiological guidance, more typically found in an ASC or a hospital outpatient setting than in a physician's office.

Response: The preponderance of comments opposing deletion of these codes from the ASC list stressed that assuring patient safety requires monitoring and special equipment not customarily found in the physician office setting. Even the minority supporting deletion noted the need for special safety measures in their comments. In light of these comments, we have retained these procedures on the ASC list (with the exception of CPT codes 64442 and 64443, which have been deleted by CPT) because as required by the conditions for coverage in §§ 416.41 and 416.44, ASCs are specifically equipped to provide the level of patient care and monitoring needed to ensure patient health and safety when these procedures are performed. In addition, ASCs are required to have in place appropriate procedures to address emergencies should they occur.

IV. Provisions of the Final Regulations

This final rule with comment period makes additions to and deletions from the current list of Medicare approved ASC procedures. In addition, this final rule with comment period responds to comments received from the June 12, 1998 proposed rule (63 FR 32290) that addressed proposed additions to and deletions from the list of ASC approved procedures. This final rule with comment period implements requirements of section 1833(i)(1) and (2) of the Act.

The addendum that follows this preamble contains the complete list of surgical procedures that are approved for an ASC facility fee payment effective for services furnished on or after July 1, 2003. The addendum also designates those CPT codes that are additions to or deletions from the current ASC list. The CPT code for each procedure is listed in column 1. In column 2, the letter “A” indicates a code that is being added to the ASC in this final rule. The letter “A*” (with an asterisk) indicates a code added to CPT since 1998 that we are adding to the list but that we did not propose to add in the June 1998 proposed rule. CPT codes designated with “A*” are those for which we are soliciting comments. The letter “D” in column 2 indicates a code that is being deleted from the ASC list. Column 3 provides the short descriptor for the CPT code in column 1. Column 4 indicates the current payment group to which an approved code is assigned. Column 5 indicates the FY 2003 payment amount for the assigned payment group. We solicit comments on additions to the ASC list designated with “A*” in column 2 and the payment group to which these additions are assigned. The codes designated by “A*” in column 2 are new CPT codes that were added to CPT in 1999, 2000, 2001, 2002, and 2003 that are similar to procedures on the updated ASC list.

V. Collection of Information Requirements

This document does not impose information collection and recordkeeping requirements. Consequently, it need not be reviewed by the Office of Management and Budget under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 35).

VI. Waiver of Proposed Rulemaking

We ordinarily publish a proposed notice in the Federal Register and invite public comment when we add to the ASC list HCPCS codes that describe new surgical procedures. The proposed notice includes a reference to the legal authority under which the additions to the list are proposed and a description of the subjects and issues involved. We solicit comment both on the appropriateness of performing the new procedures in an ASC and the payment rate that we propose as the ASC facility fee for the new procedures. This process can be waived, however, if the agency finds good cause that a notice-and-comment procedure is impracticable, unnecessary, or contrary to the public interest and incorporates a statement of the finding and its reasons in the rule that is issued.

For reasons that we explain elsewhere in this preamble, we have not previously issued a rule to make final the additions and deletions proposed in the June 12, 1998 proposed rule. For the same reasons, we have not issued proposed notices regarding the addition to the ASC list of new CPT codes that were created during the years since publication of the June 12 proposed rule. This final rule with comment adopts some provisions set forth in the June 12, 1998 proposed rule (63 FR 32290). In this final rule with comment, we are also making certain additions to the ASC list that were not proposed in the June 12 rule and that are subject to comment. Specifically, we are adding new CPT codes for surgical procedures that were added to CPT in 1999, 2000, 2001, 2002, and 2003, and we are assigning those codes to an existing ASC payment group. Start Printed Page 15275

We are making the addition of these new CPT codes to the ASC list effective for services furnished on or after July 1, 2003 because we believe that were we not to add them in this final rule, we would limit beneficiary access to surgical procedures that can be appropriately performed in the ASC setting. If these codes are not payable under the ASC benefit, beneficiaries are limited to receiving the services that they describe in a hospital setting. Also, ASCs cannot receive a facility fee for these services under the Medicare ASC benefit if we do not add them to the list. Therefore, delay in adding these new surgical procedures to the ASC list is contrary to the public interest.

Also, it is impracticable not to add the applicable new CPT codes created from 1999 through 2003 until after we have received public comments, analyzed those comments, and issued a final rule. To do so could mean that the new CPT codes would not be made final under the ASC benefit until 2004, at the earliest.

For these reasons, we find good cause to waive the notice of proposed rulemaking and to issue this final rule with comment. We are providing a 60-day public comment period regarding the addition of the new CPT codes, designated by an “A*” in the addendum and the payment group to which these codes are assigned. We will respond to timely comments in the next final notice or final rule that we issue regarding the ASC benefit.

VII. Regulatory Impact Statement

A. Overall Impact

We have examined the impact of this rule as required by Executive Order 12866 (September 1993, Regulatory Planning and Review), the Regulatory Flexibility Act (RFA) (September 16, 1980, Pub. L. 96-354), Section 1102(b) of the Social Security Act, the Unfunded Mandates Reform Act of 1995 (Pub. L. 104-4), and Executive Order 13132.

Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). Our Office of the Actuary has prepared a fiscal impact estimate. As shown in the table below, for fiscal years 2003 through 2007, the cost to the Medicare program is estimated to be $5 million per year. Therefore, this is not considered a major rule.

Fiscal yearCost 1
2003$5
20045
20055
20065
20075
1 Cost in millions, rounded to the nearest 5 million.

The RFA requires agencies to analyze options for regulatory relief of small businesses. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and government agencies. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of $6 to $29 million in any 1 year. According to the small business associations, approximately 73 percent of all ASCs are considered small entities by having revenues of $11.5 million or less. Individuals and States are not included in the definition of a small entity.

In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Metropolitan Statistical Area and has fewer than 100 beds. This rule does not have a significant impact on the operations of a substantial number of small rural hospitals.

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule that may result in expenditure in any 1 year by State, local, or tribal governments, in the aggregate, or by the private sector, of $110 million. This rule will not have an effect on the governments mentioned and the private sector costs will be less than the $110 threshold.

Executive Order 13132 establishes certain requirements that an agency must meet when it promulgates a final rule that imposes substantial direct requirement costs on State and local governments, preempts State law, or otherwise has Federalism implications. This rule will not have a substantial effect on State or local governments.

B. Anticipated Effects

The entities affected by this final rule with comment period are Medicare certified ASCs and beneficiaries. No other providers are affected. This rule will not affect state or local governments or the private sector other than ASCs. There are more than 3,000 ASCs currently certified by Medicare, nearly three-quarters of which fit the definition of a “small entity.”

The result of this rule is to increase the number of ASC procedures approved for Medicare payment by approximately 300, thereby making more surgical services payable by Medicare in an ASC available to beneficiaries. ASCs will benefit from our expanding the list of Medicare approved ASC procedures because the number of services for which Medicare will pay a facility fee will increase as a result. Currently, if ASCs perform these procedures, Medicare does not allow payment of a facility fee. Our adding these codes to the ASC list also enables ASCs to serve a greater number of beneficiaries by being able to offer access to an increased number of surgical services. The number of claims for ASC services would increase. No specific provisions of this final rule have yet been implemented. If this final rule is not issued, beneficiaries would be denied access to approximately 300 surgical procedures in the ASC setting and this would limit beneficiary choice.

Some individuals have advocated the elimination of the ASC list on the basis that the decision regarding where to perform a procedure rests ultimately with the physician. These same individuals support payment of an ASC facility fee for any surgical procedure covered by Medicare in a clinic or hospital outpatient setting. The requirements for an ASC list are imposed by the statute, so we cannot adopt this recommendation.

ASCs that specialize in dermatology, gastroenterology, and orthopedics may object to our not adding certain procedures that we proposed in our June 1998 proposed rule. In particular, we are not adding procedures performed more than 50 percent of the time in a physician's office, procedures that are not appropriately or safely performed in an ambulatory setting, or procedures that would otherwise have met the criteria for inclusion on the ASC list except that they would be significantly overpaid in the lowest ASC payment group. We have determined that the adverse economic impact on the Medicare program that could result from a shift of such services to an ASC setting outweighs the potential negative reaction of these medical specialties.

ASCs that furnish extracorporeal shockwave lithotripsy (ESWL) services may also object to our not adding this procedure to the ASC list. However, as Start Printed Page 15276we explained above, because we are not updating the ASC payment rates and ratesetting methodology in this final rule, we would not be in compliance with the District Court order issued in American Lithotripsy Society v. Sullivan, 785, F. Supp. 1035 (D.D.C. 1992) if we were to add ESWL to the ASC list without further data and information. Overall, we believe the increased beneficiary access to surgical services and the expansion of the ASC list that will result from this final rule outweighs potential objections to our not including certain additions that were proposed in 1998 to the ASC list.

For the above reasons, we are not preparing analyses for either the RFA or section 1102(b) of the Act because we have determined, and we certify, that this rule would not have a significant economic impact on a substantial number of small entities or a significant impact on the operations of a substantial number of small rural hospitals.

C. Alternatives Considered

As stated above, we are issuing this final rule with comment to implement additions to and deletions from the ASC list proposed in the June 1998 proposed rule. However, we are not implementing the ratesetting method, rebased payment rates, and changes in the regulations that were also proposed in the June 1998 proposed rule. We considered not updating the ASC list until we completed a survey of ASC costs to use in rebasing the ASC payment rates. However, we decided against this approach because it could have resulted in delaying the update of the list for several years while we conducted the survey and audited and compiled the data upon which to rebase the rates.

We considered basing payment rates for procedures being added to the ASC list in this final rule on the ASC payment group that most closely approximated the payment amount for the same procedures under the hospital outpatient prospective payment system (OPPS). However, the statute requires that payment rates be tied to ASC, not hospital outpatient costs, so we decided, as explained previously in this preamble, to match the additions to the list to procedures already on the list that are similar in terms of clinical work and resource inputs and to assign the new code to the same payment group as the current code. This approach better maintains internal consistency in ASC payment rates among codes on the list that are similar.

In accordance with the provisions of Executive Order 12866, this regulation was reviewed by the Office of Management and Budget.

Start Signature

(Catalog of Federal Domestic Assistance Program No. 93.774, Medicare—Supplementary Medical Insurance Program)

Dated: October 16, 2002.

Thomas A. Scully,

Administrator, Centers for Medicare and Medicaid Services.

Approved: February 14, 2003.

Tommy G. Thompson,

Secretary.

End Signature

Addendum: List of Medicare Approved Ambulatory Surgical Center Procedures

HCPCS CodeStatusShort descriptorPymt. groupPymt. amount
10121ARemove foreign body2446
10180Complex drainage, wound2446
11010ADebride skin, fx2446
11011ADebride skin/muscle, fx2446
11012ADebride skin/muscle/bone, fx2446
11042Debride skin/tissue2446
11043Debride tissue/muscle2446
11044Debride tissue/muscle/bone2446
11404Removal of skin lesion1333
11406Removal of skin lesion2446
11424Removal of skin lesion2446
11426Removal of skin lesion2446
11444Removal of skin lesion1333
11446Removal of skin lesion2446
11450Removal, sweat gland lesion2446
11451Removal, sweat gland lesion2446
11462Removal, sweat gland lesion2446
11463Removal, sweat gland lesion2446
11470Removal, sweat gland lesion2446
11471Removal, sweat gland lesion2446
11604Removal of skin lesion2446
11606Removal of skin lesion2446
11624Removal of skin lesion2446
11626Removal of skin lesion2446
11644Removal of skin lesion2446
11646Removal of skin lesion2446
11770Removal of pilonidal lesion3510
11771Removal of pilonidal lesion3510
11772Removal of pilonidal lesion3510
11960Insert tissue expander(s)2446
11970Replace tissue expander3510
11971Remove tissue expander(s)1333
12005Repair superficial wound(s)2446
12006Repair superficial wound(s)2446
12007Repair superficial wound(s)2446
12016Repair superficial wound(s)2446
12017Repair superficial wound(s)2446
12018Repair superficial wound(s)2446
12020Closure of split wound1333
12021Closure of split wound1333
12034Layer closure of wound(s)2446
Start Printed Page 15277
12035Layer closure of wound(s)2446
12036Layer closure of wound(s)2446
12037Layer closure of wound(s)2446
12044Layer closure of wound(s)2446
12045Layer closure of wound(s)2446
12046Layer closure of wound(s)2446
12047Layer closure of wound(s)2446
12054Layer closure of wound(s)2446
12055Layer closure of wound(s)2446
12056Layer closure of wound(s)2446
12057Layer closure of wound(s)2446
13100Repair of wound or lesion2446
13101Repair of wound or lesion3510
13120Repair of wound or lesion2446
13121Repair of wound or lesion3510
13131Repair of wound or lesion2446
13132Repair of wound or lesion3510
13150Repair of wound or lesion3510
13151Repair of wound or lesion3510
13152Repair of wound or lesion3510
13160Late closure of wound2446
14000Skin tissue rearrangement2446
14001Skin tissue rearrangement3510
14020Skin tissue rearrangement3510
14021Skin tissue rearrangement3510
14040Skin tissue rearrangement2446
14041Skin tissue rearrangement3510
14060Skin tissue rearrangement3510
14061Skin tissue rearrangement3510
14300Skin tissue rearrangement4630
14350Skin tissue rearrangement3510
15000Skin graft2446
15050Skin pinch graft2446
15100Skin split graft2446
15101Skin split graft add-on3510
15120Skin split graft2446
15121Skin split graft add-on3510
15200Skin full graft3510
15201Skin full graft add-on2446
15220Skin full graft2446
15221Skin full graft add-on2446
15240Skin full graft3510
15241Skin full graft add-on3510
15260Skin full graft2446
15261Skin full graft add-on2446
15350Skin homograft2446
15351A*Skin homograft add-on2446
15400Skin heterograft2446
15401A*Skin heterograft add-on2446
15570Form Skin pedicle flap3510
15572Form Skin pedicle flap3510
15574Form Skin pedicle flap3510
15576Form Skin pedicle flap3510
15600Skin graft3510
15610Skin graft3510
15620Skin graft4630
15630Skin graft3510
15650Transfer skin pedicle flap5717
15732Muscle-skin graft, head/neck3510
15734Muscle-skin graft, trunk3510
15736Muscle-skin graft, arm3510
15738Muscle-skin graft, leg3510
15740Island pedicle flap graft2446
15750Neurovascular pedicle graft2446
15756DFree muscle flap, microvasc3510
15757DFree skin flap, microvasc3510
15758DFree fascial flap, microvasc3510
15760Composite skin graft2446
15770Derma-fat-fascia graft3510
15775AHair transplant punch grafts3510
15776AHair transplant punch grafts3510
15820ARevision of lower eyelid3510
Start Printed Page 15278
15821ARevision of lower eyelid3510
15822ARevision of upper eyelid3510
15823ARevision of upper eyelid5717
15824ARemoval of forehead wrinkles3510
15825ARemoval of neck wrinkles3510
15826ARemoval of brow wrinkles3510
15828ARemoval of face wrinkles3510
15829ARemoval of skin wrinkles5717
15831AExcise excessive skin tissue3510
15832AExcise excessive skin tissue3510
15833AExcise excessive skin tissue3510
15834AExcise excessive skin tissue3510
15835AExcise excessive skin tissue3510
15840Graft for face nerve palsy4630
15841Graft for face nerve palsy4630
15842DFlap for face nerve palsy4630
15845Skin and muscle repair, face4630
15876ASuction assisted lipectomy3510
15877ASuction assisted lipectomy3510
15878ASuction assisted lipectomy3510
15879ASuction assisted lipectomy3510
15920Removal of tail bone ulcer3510
15922Removal of tail bone ulcer4630
15931Remove sacrum pressure sore3510
15933Remove sacrum pressure sore3510
15934Remove sacrum pressure sore3510
15935Remove sacrum pressure sore4630
15936Remove sacrum pressure sore4630
15937Remove sacrum pressure sore4630
15940Remove hip pressure sore3510
15941Remove hip pressure sore3510
15944Remove hip pressure sore3510
15945Remove hip pressure sore4630
15946Remove hip pressure sore4630
15950Remove thigh pressure sore3510
15951Remove thigh pressure sore4630
15952Remove thigh pressure sore3510
15953Remove thigh pressure sore4630
15956Remove thigh pressure sore3510
15958Remove thigh pressure sore4630
16015Treatment of burn(s)2446
16030DTreatment of burn(s)1333
16035DIncision of burn scab, initi2446
19020Incision of breast lesion2446
19100Bx breast percut w/o image1333
19101Biopsy of breast, open2446
19102Bx breast percut w/image2446
19103Bx breast percut w/device2446
19110Nipple exploration2446
19112Excise breast duct fistula3510
19120Removal of breast lesion3510
19125Excision, breast lesion3510
19126Excision, addl breast lesion3510
19140Removal of breast tissue4630
19160Removal of breast tissue3510
19162Remove breast tissue, nodes7995
19180Removal of breast4630
19182Removal of breast4630
19260DRemoval of chest wall lesion5717
19290Place needle wire, breast1333
19291Place needle wire, breast1333
19316ASuspension of breast4630
19318Reduction of large breast4630
19324AEnlarge breast4630
19325AEnlarge breast with implant91339
19328Removal of breast implant1333
19330Removal of implant material1333
19340Immediate breast prosthesis2446
19342Delayed breast prosthesis3510
19350Breast reconstruction4630
19355ACorrect inverted nipple(s)4630
19357Breast reconstruction5717
Start Printed Page 15279
19364DBreast reconstruction5717
19366Breast reconstruction5717
19370Surgery of breast capsule4630
19371Removal of breast capsule4630
19380Revise breast reconstruction5717
20005Incision of deep abscess2446
20200Muscle biopsy2446
20205Deep muscle biopsy3510
20206Needle biopsy, muscle1333
20220Bone biopsy, trocar/needle1333
20225Bone biopsy, trocar/needle2446
20240Bone biopsy, excisional2446
20245Bone biopsy, excisional3510
20250Open bone biopsy3510
20251Open bone biopsy3510
20525Removal of foreign body3510
20650Insert and remove bone pin3510
20660DApply, remove fixation device2446
20661DApplication of head brace3510
20662DApplication of pelvis brace3510
20663DApplication of thigh brace3510
20665DRemoval of fixation device1333
20670Removal of support implant1333
20680Removal of support implant3510
20690Apply bone fixation device2446
20692AApply bone fixation device3510
20693AAdjust bone fixation device3510
20694Remove bone fixation device1333
20900Removal of bone for graft3510
20902Removal of bone for graft4630
20910Remove cartilage for graft3510
20912Remove cartilage for graft3510
20920Removal of fascia for graft4630
20922Removal of fascia for graft3510
20924Removal of tendon for graft4630
20926Removal of tissue for graft4630
20955DFibula bone graft, microvasc4630
20962DOther bone graft, microvasc4630
20969DBone/skin graft, microvasc4630
20970DBone/skin graft, iliac crest4630
20972DBone/skin graft, metatarsal4630
20973DBone/skin graft, great toe4630
20975Electrical bone stimulation2446
21010Incision of jaw joint2446
21015AResection of facial tumor3510
21025Excision of bone, lower jaw2446
21026Excision of facial bone(s)2446
21029AContour of face bone lesion2446
21034Removal of face bone lesion3510
21040Removal of jaw bone lesion2446
21041DRemoval of jaw bone lesion2446
21044Removal of jaw bone lesion2446
21046AExcision, benign tumor, mandible2446
21047AExcision, benign tumor, mandible2446
21050Removal of jaw joint3510
21060Remove jaw joint cartilage2446
21070Remove coronoid process3510
21100Maxillofacial fixation2446
21121AReconstruction of chin7995
21122AReconstruction of chin7995
21123AReconstruction of chin7995
21127AAugmentation, lower jaw bone91339
21181AContour cranial bone lesion7995
21206Reconstruct upper jaw bone5717
21208Augmentation of facial bones7995
21209Reduction of facial bones5717
21210Face bone graft7995
21215Lower jaw bone graft7995
21230Rib cartilage graft7995
21235Ear cartilage graft7995
21240Reconstruction of jaw joint4630
21242Reconstruction of jaw joint5717
Start Printed Page 15280
21243Reconstruction of jaw joint5717
21244Reconstruction of lower jaw7995
21245Reconstruction of jaw7995
21246Reconstruction of jaw7995
21248Reconstruction of jaw7995
21249Reconstruction of jaw7995
21267Revise eye sockets7995
21270Augmentation, cheek bone5717
21275Revision, orbitofacial bones7995
21280Revision of eyelid5717
21282Revision of eyelid5717
21295AReconst lwr jaw w/o fixation1333
21296AReconst lwr jaw w/fixation1333
21300Treatment of skull fracture2446
21310Treatment of nose fracture2446
21315Treatment of nose fracture2446
21320Treatment of nose fracture2446
21325Treatment of nose fracture4630
21330Treatment of nose fracture5717
21335Treatment of nose fracture7995
21336ATreat nasal septal fracture4630
21337Treat nasal septal fracture2446
21338Treat nasoethmoid fracture4630
21339Treat nasoethmoid fracture5717
21340Treatment of nose fracture4630
21343DTreatment of sinus fracture5717
21345ATreat nose/jaw fracture7995
21355Treat cheek bone fracture3510
21360DTreat cheek bone fracture4630
21365Treat cheek bone fracture5717
21385DTreat eye socket fracture5717
21386DTreat eye socket fracture5717
21387DTreat eye socket fracture5717
21390DTreat eye socket fracture7995
21395DTreat eye socket fracture7995
21400Treat eye socket fracture2446
21401Treat eye socket fracture3510
21406DTreat eye socket fracture4630
21407DTreat eye socket fracture5717
21421Treat mouth roof fracture4630
21422DTreat mouth roof fracture5717
21440Treat dental ridge fracture3510
21445Treat dental ridge fracture4630
21450Treat lower jaw fracture3510
21451Treat lower jaw fracture4630
21452Treat lower jaw fracture2446
21453Treat lower jaw fracture3510
21454Treat lower jaw fracture5717
21461Treat lower jaw fracture4630
21462Treat lower jaw fracture5717
21465Treat lower jaw fracture4630
21470DTreat lower jaw fracture5717
21480Reset dislocated jaw1333
21485Reset dislocated jaw2446
21490Repair dislocated jaw3510
21493Treat hyoid bone fracture3510
21494Treat hyoid bone fracture4630
21495DTreat hyoid bone fracture4630
21497Interdental wiring2446
21501Drain neck/chest lesion2446
21502Drain chest lesion2446
21510DDrainage of bone lesion3510
21550DBiopsy of neck/chest1333
21555Remove lesion, neck/chest2446
21556Remove lesion, neck/chest2446
21600Partial removal of rib2446
21610Partial removal of rib2446
21620DPartial removal of sternum2446
21700Revision of neck muscle2446
21720Revision of neck muscle3510
21725Revision of neck muscle3510
21800Treatment of rib fracture1333
Start Printed Page 15281
21805Treatment of rib fracture2446
21810DTreatment of rib fracture(s)2446
21820Treat sternum fracture1333
21920DBiopsy soft tissue of back1333
21925Biopsy soft tissue of back2446
21930Remove lesion, back or flank2446
21935Remove tumor, back3510
22100DRemove part of neck vertebra3510
22101DRemove part, thorax vertebra3510
22102DRemove part, lumbar vertebra3510
22103DRemove extra spine segment3510
22305Treat spine process fracture1333
22310Treat spine fracture1333
22315Treat spine fracture2446
22325DTreat spine fracture3510
22326DTreat neck spine fracture3510
22327DTreat thorax spine fracture3510
22328DTreat each add spine fx3510
22505Manipulation of spine2446
22900Remove abdominal wall lesion4630
23000Removal of calcium deposits2446
23020Release shoulder joint2446
23030Drain shoulder lesion1333
23031ADrain shoulder bursa3510
23035Drain shoulder bone lesion3510
23040Exploratory shoulder surgery3510
23044Exploratory shoulder surgery4630
23065DBiopsy shoulder tissues1333
23066Biopsy shoulder tissues2446
23075Removal of shoulder lesion2446
23076Removal of shoulder lesion2446
23077Remove tumor of shoulder3510
23100Biopsy of shoulder joint2446
23101Shoulder joint surgery7995
23105Remove shoulder joint lining4630
23106Incision of collarbone joint4630
23107Explore treat shoulder joint4630
23120Partial removal, collar bone5717
23125Removal of collar bone5717
23130Remove shoulder bone, part5717
23140Removal of bone lesion4630
23145Removal of bone lesion5717
23146Removal of bone lesion5717
23150Removal of humerus lesion4630
23155Removal of humerus lesion5717
23156Removal of humerus lesion5717
23170Remove collar bone lesion2446
23172Remove shoulder blade lesion2446
23174Remove humerus lesion2446
23180Remove collar bone lesion4630
23182Remove shoulder blade lesion4630
23184Remove humerus lesion4630
23190Partial removal of scapula4630
23195Removal of head of humerus5717
23330Remove shoulder foreign body1333
23331Remove shoulder foreign body1333
23395Muscle transfer, shoulder/arm5717
23397Muscle transfers7995
23400Fixation of shoulder blade7995
23405Incision of tendon & muscle2446
23406Incise tendon(s) & muscle(s)2446
23410Repair of tendon(s)5717
23412Repair of tendon(s)7995
23415Release of shoulder ligament5717
23420Repair of shoulder7995
23430Repair biceps tendon4630
23440Remove/transplant tendon4630
23450Repair shoulder capsule5717
23455Repair shoulder capsule7995
23460Repair shoulder capsule5717
23462Repair shoulder capsule7995
23465Repair shoulder capsule5717
Start Printed Page 15282
23466Repair shoulder capsule7995
23480Revision of collar bone4630
23485Revision of collar bone7995
23490Reinforce clavicle3510
23491Reinforce shoulder bones3510
23500Treat clavicle fracture1333
23505Treat clavicle fracture1333
23515Treat clavicle fracture3510
23520Treat clavicle dislocation1333
23525Treat clavicle dislocation1333
23530Treat clavicle dislocation3510
23532Treat clavicle dislocation4630
23540Treat clavicle dislocation1333
23545Treat clavicle dislocation1333
23550Treat clavicle dislocation3510
23552Treat clavicle dislocation4630
23570Treat shoulder blade fx1333
23575Treat shoulder blade fx1333
23585Treat scapula fracture3510
23600Treat humerus fracture1333
23605Treat humerus fracture2446
23615Treat humerus fracture4630
23616Treat humerus fracture4630
23620Treat humerus fracture1333
23625Treat humerus fracture2446
23630Treat humerus fracture5717
23650Treat shoulder dislocation1333
23655Treat shoulder dislocation1333
23660Treat shoulder dislocation3510
23665Treat dislocation/fracture2446
23670Treat dislocation/fracture3510
23675Treat dislocation/fracture2446
23680Treat dislocation/fracture3510
23700Fixation of shoulder1333
23800Fusion of shoulder joint4630
23802Fusion of shoulder joint7995
23921Amputation follow-up surgery3510
23930Drainage of arm lesion1333
23931Drainage of arm bursa2446
23935Drain arm/elbow bone lesion2446
24000Exploratory elbow surgery4630
24006ARelease elbow joint4630
24065DBiopsy arm/elbow soft tissue1333
24066Biopsy arm/elbow soft tissue2446
24075Remove arm/elbow lesion2446
24076Remove arm/elbow lesion2446
24077Remove tumor of arm/elbow3510
24100Biopsy elbow joint lining1333
24101Explore/treat elbow joint4630
24102Remove elbow joint lining4630
24105Removal of elbow bursa3510
24110Remove humerus lesion2446
24115Remove/graft bone lesion3510
24116Remove/graft bone lesion3510
24120Remove elbow lesion3510
24125Remove/graft bone lesion3510
24126Remove/graft bone lesion3510
24130Removal of head of radius3510
24134Removal of arm bone lesion2446
24136Remove radius bone lesion2446
24138Remove elbow bone lesion2446
24140Partial removal of arm bone3510
24145Partial removal of radius3510
24147Partial removal of elbow2446
24150DExtensive humerus surgery3510
24151DExtensive humerus surgery4630
24152DExtensive radius surgery3510
24153DExtensive radius surgery4630
24155Removal of elbow joint3510
24160Remove elbow joint implant2446
24164Remove radius head implant3510
24201Removal of arm foreign body2446
Start Printed Page 15283
24301Muscle/tendon transfer4630
24305AArm tendon lengthening4630
24310Revision of arm tendon3510
24320Repair of arm tendon3510
24330Revision of arm muscles3510
24331Revision of arm muscles3510
24340Repair of biceps tendon3510
24341ARepair arm tendon/muscle3510
24342Repair of ruptured tendon3510
24345A*Repr elbw med ligmnt w/tissu2446
24350Repair of tennis elbow3510
24351Repair of tennis elbow3510
24352Repair of tennis elbow3510
24354Repair of tennis elbow3510
24356Revision of tennis elbow3510
24360Reconstruct elbow joint5717
24361Reconstruct elbow joint5717
24362Reconstruct elbow joint5717
24363Replace elbow joint7995
24365Reconstruct head of radius5717
24366Reconstruct head of radius5717
24400Revision of humerus4630
24410Revision of humerus4630
24420Revision of humerus3510
24430Repair of humerus3510
24435Repair humerus with graft4630
24470Revision of elbow joint3510
24495Decompression of forearm2446
24498Reinforce humerus3510
24500Treat humerus fracture1333
24505Treat humerus fracture1333
24515Treat humerus fracture4630
24516Treat humerus fracture4630
24530Treat humerus fracture1333
24535Treat humerus fracture1333
24538Treat humerus fracture2446
24545Treat humerus fracture4630
24546Treat humerus fracture5717
24560Treat humerus fracture1333
24565Treat humerus fracture2446
24566Treat humerus fracture2446
24575Treat humerus fracture3510
24576Treat humerus fracture1333
24577Treat humerus fracture1333
24579Treat humerus fracture3510
24582Treat humerus fracture2446
24586Treat elbow fracture4630
24587Treat elbow fracture5717
24600Treat elbow dislocation1333
24605Treat elbow dislocation2446
24615Treat elbow dislocation3510
24620Treat elbow fracture2446
24635Treat elbow fracture3510
24655Treat radius fracture1333
24665Treat radius fracture4630
24666Treat radius fracture4630
24670Treat ulnar fracture1333
24675Treat ulnar fracture1333
24685Treat ulnar fracture3510
24800Fusion of elbow joint4630
24802Fusion/graft of elbow joint5717
24925Amputation follow-up surgery3510
25000Incision of tendon sheath3510
25020Decompress forearm 1 space3510
25023Decompress forearm 1 space3510
25024Decompress forearm 2 spaces3510
25025Decompress forearm 2 spaces3510
25028Drainage of forearm lesion1333
25031Drainage of forearm bursa2446
25035Treat forearm bone lesion2446
25040Explore/treat wrist joint5717
25065DBiopsy forearm soft tissues1333
Start Printed Page 15284
25066Biopsy forearm soft tissues2446
25075Remove forearm lesion subcut2446
25076Remove forearm lesion deep3510
25077Remove tumor, forearm/wrist3510
25085Incision of wrist capsule3510
25100Biopsy of wrist joint2446
25101Explore/treat wrist joint3510
25105Remove wrist joint lining4630
25107Remove wrist joint cartilage3510
25110Remove wrist tendon lesion3510
25111Remove wrist tendon lesion3510
25112Reremove wrist tendon lesion4630
25115Remove wrist/forearm lesion4630
25116Remove wrist/forearm lesion4630
25118Excise wrist tendon sheath2446
25119Partial removal of ulna3510
25120Removal of forearm lesion3510
25125Remove/graft forearm lesion3510
25126Remove/graft forearm lesion3510
25130Removal of wrist lesion3510
25135Remove & graft wrist lesion3510
25136Remove & graft wrist lesion3510
25145Remove forearm bone lesion2446
25150Partial removal of ulna2446
25151Partial removal of radius2446
25170DExtensive forearm surgery3510
25210Removal of wrist bone3510
25215Removal of wrist bones4630
25230Partial removal of radius4630
25240Partial removal of ulna4630
25248Remove forearm foreign body2446
25250Removal of wrist prosthesis1333
25251Removal of wrist prosthesis1333
25260Repair forearm tendon/muscle4630
25263Repair forearm tendon/muscle2446
25265Repair forearm tendon/muscle3510
25270Repair forearm tendon/muscle4630
25272Repair forearm tendon/muscle3510
25274Repair forearm tendon/muscle4630
25275Repair forearm tendon sheath4630
25280Revise wrist/forearm tendon4630
25290Incise wrist/forearm tendon3510
25295Release wrist/forearm tendon3510
25300Fusion of tendons at wrist3510
25301Fusion of tendons at wrist3510
25310Transplant forearm tendon3510
25312Transplant forearm tendon4630
25315Revise palsy hand tendon(s)3510
25316Revise palsy hand tendon(s)3510
25320Repair/revise wrist joint3510
25332Revise wrist joint5717
25335Realignment of hand3510
25337AReconstruct ulna/radioulnar5717
25350Revision of radius3510
25355Revision of radius3510
25360Revision of ulna3510
25365Revise radius & ulna3510
25370Revise radius or ulna3510
25375Revise radius & ulna4630
25390Shorten radius or ulna3510
25391Lengthen radius or ulna4630
25392Shorten radius & ulna3510
25393Lengthen radius & ulna4630
25400Repair radius or ulna3510
25405Repair/graft radius or ulna4630
25415Repair radius & ulna3510
25420Repair/graft radius & ulna4630
25425Repair/graft radius or ulna3510
25426Repair/graft radius & ulna4630
25440Repair/graft wrist bone4630
25441Reconstruct wrist joint5717
25442Reconstruct wrist joint5717
Start Printed Page 15285
25443Reconstruct wrist joint5717
25444Reconstruct wrist joint5717
25445Reconstruct wrist joint5717
25446Wrist replacement7995
25447Repair wrist joint(s)5717
25449Remove wrist joint implant5717
25450Revision of wrist joint3510
25455Revision of wrist joint3510
25490Reinforce radius3510
25491Reinforce ulna3510
25492Reinforce radius and ulna3510
25505Treat fracture of radius1333
25515Treat fracture of radius3510
25520Treat fracture of radius1333
25525Treat fracture of radius4630
25526Treat fracture of radius5717
25535Treat fracture of ulna1333
25545Treat fracture of ulna3510
25565Treat fracture radius & ulna2446
25574Treat fracture radius & ulna3510
25575Treat fracture radius/ulna3510
25605Treat fracture radius/ulna3510
25611Treat fracture radius/ulna3510
25620Treat fracture radius/ulna5717
25624Treat wrist bone fracture2446
25628Treat wrist bone fracture3510
25635Treat wrist bone fracture1333
25645Treat wrist bone fracture3510
25660Treat wrist dislocation1333
25670Treat wrist dislocation3510
25671Pin radioulnar dislocation1333
25675Treat wrist dislocation1333
25676Treat wrist dislocation2446
25680Treat wrist fracture2446
25685Treat wrist fracture3510
25690Treat wrist dislocation1333
25695Treat wrist dislocation2446
25800Fusion of wrist joint4630
25805Fusion/graft of wrist joint5717
25810Fusion/graft of wrist joint5717
25820Fusion of hand bones4630
25825Fuse hand bones with graft5717
25830AFusion, radioulnar jnt/ulna5717
25907Amputation follow-up surgery3510
25922Amputate hand at wrist3510
25929Amputation follow-up surgery3510
26011Drainage of finger abscess1333
26020Drain hand tendon sheath2446
26025Drainage of palm bursa1333
26030Drainage of palm bursa(s)2446
26034Treat hand bone lesion2446
26035DDecompress fingers/hand4630
26037DDecompress fingers/hand4630
26040Release palm contracture4630
26045Release palm contracture3510
26055Incise finger tendon sheath2446
26060Incision of finger tendon2446
26070Explore/treat hand joint2446
26075Explore/treat finger joint4630
26080Explore/treat finger joint4630
26100Biopsy hand joint lining2446
26105Biopsy finger joint lining1333
26110Biopsy finger joint lining1333
26115Remove hand lesion subcut2446
26116Remove hand lesion, deep2446
26117Remove tumor, hand/finger3510
26121Release palm contracture4630
26123Release palm contracture4630
26125Release palm contracture4630
26130Remove wrist joint lining3510
26135Revise finger joint, each4630
26140Revise finger joint, each2446
Start Printed Page 15286
26145Tendon excision, palm/finger3510
26160Remove tendon sheath lesion3510
26170Removal of palm tendon, each3510
26180Removal of finger tendon3510
26185ARemove finger bone4630
26200Remove hand bone lesion2446
26205Remove/graft bone lesion3510
26210Removal of finger lesion2446
26215Remove/graft finger lesion3510
26230Partial removal of hand bone7995
26235Partial removal, finger bone3510
26236Partial removal, finger bone3510
26250Extensive hand surgery3510
26255Extensive hand surgery3510
26260Extensive finger surgery3510
26261Extensive finger surgery3510
26262Partial removal of finger2446
26320Removal of implant from hand2446
26350Repair finger/hand tendon1333
26352Repair/graft hand tendon4630
26356Repair finger/hand tendon4630
26357Repair finger/hand tendon4630
26358Repair/graft hand tendon4630
26370Repair finger/hand tendon4630
26372Repair/graft hand tendon4630
26373Repair finger/hand tendon3510
26390Revise hand/finger tendon4630
26392Repair/graft hand tendon3510
26410Repair hand tendon3510
26412Repair/graft hand tendon3510
26415Excision, hand/finger tendon4630
26416Graft hand or finger tendon3510
26418Repair finger tendon4630
26420Repair/graft finger tendon4630
26426Repair finger/hand tendon3510
26428Repair/graft finger tendon3510
26432Repair finger tendon3510
26433Repair finger tendon3510
26434Repair/graft finger tendon3510
26437Realignment of tendons3510
26440Release palm/finger tendon3510
26442Release palm & finger tendon3510
26445Release hand/finger tendon3510
26449Release forearm/hand tendon3510
26450Incision of palm tendon3510
26455Incision of finger tendon3510
26460Incise hand/finger tendon3510
26471Fusion of finger tendons2446
26474Fusion of finger tendons2446
26476Tendon lengthening1333
26477Tendon shortening1333
26478Lengthening of hand tendon1333
26479Shortening of hand tendon1333
26480Transplant hand tendon3510
26483Transplant/graft hand tendon3510
26485Transplant palm tendon2446
26489Transplant/graft palm tendon3510
26490Revise thumb tendon3510
26492Tendon transfer with graft3510
26494Hand tendon/muscle transfer3510
26496Revise thumb tendon3510
26497Finger tendon transfer3510
26498Finger tendon transfer4630
26499Revision of finger3510
26500Hand tendon reconstruction4630
26502Hand tendon reconstruction4630
26504Hand tendon reconstruction4630
26508Release thumb contracture3510
26510Thumb tendon transfer3510
26516Fusion of knuckle joint1333
26517Fusion of knuckle joints3510
26518Fusion of knuckle joints3510
Start Printed Page 15287
26520Release knuckle contracture3510
26525Release finger contracture3510
26530Revise knuckle joint3510
26531Revise knuckle with implant7995
26535Revise finger joint5717
26536Revise/implant finger joint5717
26540Repair hand joint4630
26541Repair hand joint with graft7995
26542Repair hand joint with graft4630
26545Reconstruct finger joint4630
26546ARepair nonunion hand4630
26548Reconstruct finger joint4630
26550Construct thumb replacement2446
26551DGreat toe-hand transfer4630
26553DSingle transfer, toe-hand2446
26554DDouble transfer, toe-hand2446
26555Positional change of finger3510
26560Repair of web finger2446
26561Repair of web finger3510
26562Repair of web finger4630
26565Correct metacarpal flaw5717
26567Correct finger deformity5717
26568Lengthen metacarpal/finger3510
26580Repair hand deformity5717
26587Reconstruct extra finger5717
26590Repair finger deformity5717
26591Repair muscles of hand3510
26593Release muscles of hand3510
26596Excision constricting tissue2446
26605Treat metacarpal fracture2446
26607Treat metacarpal fracture2446
26608ATreat metacarpal fracture4630
26615Treat metacarpal fracture4630
26645Treat thumb fracture1333
26650Treat thumb fracture2446
26665Treat thumb fracture4630
26675Treat hand dislocation2446
26676Pin hand dislocation2446
26685Treat hand dislocation3510
26686Treat hand dislocation3510
26705Treat knuckle dislocation2446
26706Pin knuckle dislocation2446
26715Treat knuckle dislocation4630
26727Treat finger fracture, each7995
26735Treat finger fracture, each4630
26742Treat finger fracture, each2446
26746Treat finger fracture, each5717
26756Pin finger fracture, each2446
26765Treat finger fracture, each4630
26776Pin finger dislocation2446
26785Treat finger dislocation2446
26820Thumb fusion with graft5717
26841Fusion of thumb4630
26842Thumb fusion with graft4630
26843Fusion of hand joint3510
26844Fusion/graft of hand joint3510
26850Fusion of knuckle4630
26852Fusion of knuckle with graft4630
26860Fusion of finger joint3510
26861Fusion of finger jnt, add-on2446
26862Fusion/graft of finger joint4630
26863Fuse/graft added joint3510
26910Amputate metacarpal bone3510
26951Amputation of finger/thumb2446
26952Amputation of finger/thumb4630
26990Drainage of pelvis lesion1333
26991Drainage of pelvis bursa1333
26992DDrainage of bone lesion2446
27000Incision of hip tendon2446
27001Incision of hip tendon3510
27003Incision of hip tendon3510
27030DDrainage of hip joint3510
Start Printed Page 15288
27033Exploration of hip joint3510
27035Denervation of hip joint4630
27040Biopsy of soft tissues1333
27041Biopsy of soft tissues2446
27047Remove hip/pelvis lesion2446
27048Remove hip/pelvis lesion3510
27049Remove tumor, hip/pelvis3510
27050Biopsy of sacroiliac joint3510
27052Biopsy of hip joint3510
27060Removal of ischial bursa5717
27062Remove femur lesion/bursa5717
27065Removal of hip bone lesion5717
27066Removal of hip bone lesion5717
27067ARemove/graft hip bone lesion5717
27080Removal of tail bone2446
27086Remove hip foreign body1333
27087Remove hip foreign body3510
27097Revision of hip tendon3510
27098Transfer tendon to pelvis3510
27100Transfer of abdominal muscle4630
27105Transfer of spinal muscle4630
27110Transfer of iliopsoas muscle4630
27111Transfer of iliopsoas muscle4630
27193Treat pelvic ring fracture1333
27194Treat pelvic ring fracture2446
27202Treat tail bone fracture2446
27230Treat thigh fracture1333
27238Treat thigh fracture1333
27246Treat thigh fracture1333
27250Treat hip dislocation1333
27252Treat hip dislocation2446
27257ATreat hip dislocation3510
27265Treat hip dislocation1333
27266Treat hip dislocation2446
27275Manipulation of hip joint2446
27301Drain thigh/knee lesion3510
27303DDrainage of bone lesion2446
27305Incise thigh tendon & fascia2446
27306Incision of thigh tendon3510
27307Incision of thigh tendons3510
27310Exploration of knee joint4630
27315Partial removal, thigh nerve2446
27320Partial removal, thigh nerve2446
27323Biopsy, thigh soft tissues1333
27324Biopsy, thigh soft tissues1333
27327Removal of thigh lesion2446
27328Removal of thigh lesion3510
27329ARemove tumor, thigh/knee4630
27330Biopsy, knee joint lining4630
27331Explore/treat knee joint4630
27332Removal of knee cartilage4630
27333Removal of knee cartilage4630
27334Remove knee joint lining4630
27335Remove knee joint lining4630
27340Removal of kneecap bursa3510
27345Removal of knee cyst4630
27347A*Remove knee cyst4630
27350Removal of kneecap4630
27355Remove femur lesion3510
27356Remove femur lesion/graft4630
27357ARemove femur lesion/graft5717
27358ARemove femur lesion/fixation5717
27360Partial removal, leg bone(s)5717
27372Removal of foreign body7995
27380Repair of kneecap tendon1333
27381Repair/graft kneecap tendon3510
27385Repair of thigh muscle3510
27386Repair/graft of thigh muscle3510
27390Incision of thigh tendon1333
27391Incision of thigh tendons2446
27392Incision of thigh tendons3510
27393Lengthening of thigh tendon2446
Start Printed Page 15289
27394Lengthening of thigh tendons3510
27395Lengthening of thigh tendons3510
27396Transplant of thigh tendon3510
27397Transplants of thigh tendons3510
27400Revise thigh muscles/tendons3510
27403Repair of knee cartilage4630
27405Repair of knee ligament4630
27407Repair of knee ligament4630
27409Repair of knee ligaments4630
27418Repair degenerated kneecap3510
27420Revision of unstable kneecap3510
27422Revision of unstable kneecap7995
27424Revision/removal of kneecap3510
27425Lateral retinacular release7995
27427Reconstruction, knee3510
27428Reconstruction, knee4630
27429Reconstruction, knee4630
27430Revision of thigh muscles4630
27435Incision of knee joint4630
27437Revise kneecap4630
27438Revise kneecap with implant5717
27440DRevision of knee joint5717
27441Revision of knee joint5717
27442Revision of knee joint5717
27443Revision of knee joint5717
27496ADecompression of thigh/knee5717
27497ADecompression of thigh/knee3510
27498ADecompression of thigh/knee3510
27499ADecompression of thigh/knee3510
27500Treatment of thigh fracture1333
27501Treatment of thigh fracture2446
27502Treatment of thigh fracture2446
27503Treatment of thigh fracture3510
27507DTreatment of thigh fracture4630
27508Treatment of thigh fracture1333
27509Treatment of thigh fracture3510
27510Treatment of thigh fracture1333
27511DTreatment of thigh fracture4630
27513DTreatment of thigh fracture5717
27516Treat thigh fx growth plate1333
27517Treat thigh fx growth plate1333
27520Treat kneecap fracture1333
27524DTreat kneecap fracture3510
27530Treat knee fracture1333
27532Treat knee fracture1333
27535DTreat knee fracture3510
27538Treat knee fracture(s)1333
27550Treat knee dislocation1333
27552Treat knee dislocation1333
27560Treat kneecap dislocation1333
27562Treat kneecap dislocation1333
27566Treat kneecap dislocation2446
27570Fixation of knee joint1333
27594AAmputation follow-up surgery3510
27600ADecompression of lower leg3510
27601ADecompression of lower leg3510
27602ADecompression of lower leg3510
27603Drain lower leg lesion2446
27604Drain lower leg bursa2446
27605Incision of achilles tendon1333
27606Incision of achilles tendon1333
27607Treat lower leg bone lesion2446
27610Explore/treat ankle joint2446
27612Exploration of ankle joint3510
27613DBiopsy lower leg soft tissue1333
27614Biopsy lower leg soft tissue2446
27615Remove tumor, lower leg3510
27618Remove lower leg lesion2446
27619Remove lower leg lesion3510
27620Explore/treat ankle joint4630
27625Remove ankle joint lining4630
27626Remove ankle joint lining4630
Start Printed Page 15290
27630Removal of tendon lesion3510
27635Remove lower leg bone lesion3510
27637Remove/graft leg bone lesion3510
27638Remove/graft leg bone lesion3510
27640Partial removal of tibia2446
27641Partial removal of fibula2446
27647AExtensive ankle/heel surgery3510
27650Repair achilles tendon3510
27652Repair/graft achilles tendon3510
27654Repair of achilles tendon3510
27656Repair leg fascia defect2446
27658Repair of leg tendon, each1333
27659Repair of leg tendon, each2446
27664Repair of leg tendon, each2446
27665Repair of leg tendon, each2446
27675Repair lower leg tendons2446
27676Repair lower leg tendons3510
27680Release of lower leg tendon3510
27681Release of lower leg tendons2446
27685Revision of lower leg tendon3510
27686Revise lower leg tendons3510
27687Revision of calf tendon3510
27690Revise lower leg tendon4630
27691Revise lower leg tendon4630
27692Revise additional leg tendon3510
27695Repair of ankle ligament2446
27696Repair of ankle ligaments2446
27698Repair of ankle ligament2446
27700Revision of ankle joint5717
27704Removal of ankle implant2446
27705Incision of tibia2446
27707Incision of fibula2446
27709Incision of tibia & fibula2446
27715DRevision of lower leg4630
27730Repair of tibia epiphysis2446
27732Repair of fibula epiphysis2446
27734Repair lower leg epiphyses2446
27740Repair of leg epiphyses2446
27742Repair of leg epiphyses2446
27745Reinforce tibia3510
27750Treatment of tibia fracture1333
27752Treatment of tibia fracture1333
27756Treatment of tibia fracture3510
27758Treatment of tibia fracture4630
27759Treatment of tibia fracture4630
27760Treatment of ankle fracture1333
27762Treatment of ankle fracture1333
27766Treatment of ankle fracture3510
27780Treatment of fibula fracture1333
27781Treatment of fibula fracture1333
27784Treatment of fibula fracture3510
27786Treatment of ankle fracture1333
27788Treatment of ankle fracture1333
27792Treatment of ankle fracture3510
27808Treatment of ankle fracture1333
27810Treatment of ankle fracture1333
27814Treatment of ankle fracture3510
27816Treatment of ankle fracture1333
27818Treatment of ankle fracture1333
27822Treatment of ankle fracture3510
27823Treatment of ankle fracture3510
27824Treat lower leg fracture1333
27825Treat lower leg fracture2446
27826Treat lower leg fracture3510
27827Treat lower leg fracture3510
27828Treat lower leg fracture4630
27829Treat lower leg joint2446
27830Treat lower leg dislocation1333
27831Treat lower leg dislocation1333
27832Treat lower leg dislocation2446
27840Treat ankle dislocation1333
27842Treat ankle dislocation1333
Start Printed Page 15291
27846Treat ankle dislocation3510
27848Treat ankle dislocation3510
27860Fixation of ankle joint1333
27870Fusion of ankle joint4630
27871Fusion of tibiofibular joint4630
27884Amputation follow-up surgery3510
27889AAmputation of foot at ankle3510
27892ADecompression of leg3510
27893ADecompression of leg3510
27894ADecompression of leg3510
28002Treatment of foot infection3510
28003Treatment of foot infection3510
28005Treat foot bone lesion3510
28008Incision of foot fascia3510
28011AIncision of toe tendons3510
28020Exploration of foot joint2446
28022AExploration of foot joint2446
28024AExploration of toe joint2446
28030Removal of foot nerve4630
28035Decompression of tibia nerve4630
28043Excision of foot lesion2446
28045Excision of foot lesion3510
28046Resection of tumor, foot3510
28050Biopsy of foot joint lining2446
28052ABiopsy of foot joint lining2446
28054Biopsy of toe joint lining2446
28060Partial removal, foot fascia2446
28062Removal of foot fascia3510
28070Removal of foot joint lining3510
28072Removal of foot joint lining3510
28080Removal of foot lesion3510
28086Excise foot tendon sheath2446
28088Excise foot tendon sheath2446
28090Removal of foot lesion3510
28092Removal of toe lesions3510
28100Removal of ankle/heel lesion2446
28102Remove/graft foot lesion3510
28103Remove/graft foot lesion3510
28104Removal of foot lesion2446
28106Remove/graft foot lesion3510
28107Remove/graft foot lesion3510
28110Part removal of metatarsal3510
28111Part removal of metatarsal3510
28112Part removal of metatarsal3510
28113Part removal of metatarsal3510
28114Removal of metatarsal heads3510
28116Revision of foot3510
28118Removal of heel bone4630
28119Removal of heel spur4630
28120Part removal of ankle/heel7995
28122Partial removal of foot bone3510
28126APartial removal of toe3510
28130Removal of ankle bone3510
28140Removal of metatarsal3510
28150Removal of toe3510
28153APartial removal of toe3510
28160APartial removal of toe3510
28171Extensive foot surgery3510
28173Extensive foot surgery3510
28175Extensive foot surgery3510
28192Removal of foot foreign body2446
28193Removal of foot foreign body4630
28200Repair of foot tendon3510
28202Repair/graft of foot tendon3510
28208Repair of foot tendon3510
28210Repair/graft of foot tendon3510
28222Release of foot tendons1333
28225Release of foot tendon1333
28226Release of foot tendons1333
28234AIncision of foot tendon2446
28238Revision of foot tendon3510
28240Release of big toe2446
Start Printed Page 15292
28250Revision of foot fascia3510
28260Release of midfoot joint3510
28261Revision of foot tendon3510
28262Revision of foot and ankle4630
28264Release of midfoot joint1333
28270ARelease of foot contracture3510
28280Fusion of toes2446
28285Repair of hammertoe3510
28286Repair of hammertoe4630
28288Partial removal of foot bone3510
28289A*Repair hallux rigidus3510
28290Correction of bunion2446
28292Correction of bunion2446
28293Correction of bunion3510
28294Correction of bunion3510
28296Correction of bunion3510
28297Correction of bunion3510
28298Correction of bunion3510
28299Correction of bunion5717
28300Incision of heel bone2446
28302Incision of ankle bone2446
28304Incision of midfoot bones2446
28305Incise/graft midfoot bones3510
28306Incision of metatarsal4630
28307Incision of metatarsal4630
28308Incision of metatarsal2446
28309Incision of metatarsals4630
28310Revision of big toe3510
28312Revision of toe3510
28313Repair deformity of toe2446
28315Removal of sesamoid bone4630
28320Repair of foot bones4630
28322Repair of metatarsals4630
28340Resect enlarged toe tissue4630
28341Resect enlarged toe4630
28344Repair extra toe(s)4630
28345Repair webbed toe(s)4630
28400Treatment of heel fracture1333
28405Treatment of heel fracture2446
28406Treatment of heel fracture2446
28415Treat heel fracture3510
28420Treat/graft heel fracture4630
28435Treatment of ankle fracture2446
28436Treatment of ankle fracture2446
28445Treat ankle fracture3510
28456Treat midfoot fracture2446
28465Treat midfoot fracture, each3510
28476Treat metatarsal fracture2446
28485Treat metatarsal fracture4630
28496Treat big toe fracture2446
28505Treat big toe fracture3510
28525Treat toe fracture3510
28531ATreat sesamoid bone fracture3510
28545Treat foot dislocation1333
28546Treat foot dislocation2446
28555Repair foot dislocation2446
28575Treat foot dislocation1333
28576Treat foot dislocation3510
28585Repair foot dislocation3510
28605Treat foot dislocation1333
28606Treat foot dislocation2446
28615Repair foot dislocation3510
28635Treat toe dislocation1333
28636Treat toe dislocation3510
28645Repair toe dislocation3510
28665Treat toe dislocation1333
28666Treat toe dislocation3510
28675Repair of toe dislocation3510
28705Fusion of foot bones4630
28715Fusion of foot bones4630
28725Fusion of foot bones4630
28730Fusion of foot bones4630
Start Printed Page 15293
28735Fusion of foot bones4630
28737Revision of foot bones5717
28740Fusion of foot bones4630
28750Fusion of big toe joint4630
28755Fusion of big toe joint4630
28760Fusion of big toe joint4630
28810Amputation toe & metatarsal2446
28820Amputation of toe2446
28825Partial amputation of toe2446
29800AJaw arthroscopy/surgery3510
29804Jaw arthroscopy/surgery3510
29805Shoulder arthroscopy, dx3510
29806Shoulder arthroscopy/surgery3510
29807Shoulder arthroscopy/surgery3510
29819Shoulder arthroscopy/surgery3510
29820Shoulder arthroscopy/surgery3510
29821Shoulder arthroscopy/surgery3510
29822Shoulder arthroscopy/surgery3510
29823Shoulder arthroscopy/surgery3510
29824Shoulder arthroscopy/surgery5717
29825Shoulder arthroscopy/surgery3510
29826Shoulder arthroscopy/surgery3510
29827A*Arthroscop rotator cuff repr5717
29830Elbow arthroscopy3510
29834Elbow arthroscopy/surgery3510
29835Elbow arthroscopy/surgery3510
29836Elbow arthroscopy/surgery3510
29837Elbow arthroscopy/surgery3510
29838Elbow arthroscopy/surgery3510
29840Wrist arthroscopy3510
29843Wrist arthroscopy/surgery3510
29844Wrist arthroscopy/surgery3510
29845Wrist arthroscopy/surgery3510
29846Wrist arthroscopy/surgery3510
29847Wrist arthroscopy/surgery3510
29848AWrist endoscopy/surgery91339
29850Knee arthroscopy/surgery4630
29851Knee arthroscopy/surgery4630
29855Tibial arthroscopy/surgery4630
29856Tibial arthroscopy/surgery4630
29860AHip arthroscopy, dx4630
29861AHip arthroscopy/surgery4630
29862AHip arthroscopy/surgery91339
29863AHip arthroscopy/surgery4630
29870Knee arthroscopy, dx3510
29871Knee arthroscopy/drainage3510
29874Knee arthroscopy/surgery3510
29875Knee arthroscopy/surgery4630
29876Knee arthroscopy/surgery4630
29877Knee arthroscopy/surgery4630
29879Knee arthroscopy/surgery3510
29880Knee arthroscopy/surgery4630
29881Knee arthroscopy/surgery4630
29882Knee arthroscopy/surgery3510
29883Knee arthroscopy/surgery3510
29884Knee arthroscopy/surgery3510
29885Knee arthroscopy/surgery3510
29886Knee arthroscopy/surgery3510
29887Knee arthroscopy/surgery3510
29888Knee arthroscopy/surgery3510
29889Knee arthroscopy/surgery3510
29891AAnkle arthroscopy/surgery3510
29892AAnkle arthroscopy/surgery3510
29893AScope, plantar fasciotomy91339
29894Ankle arthroscopy/surgery3510
29895Ankle arthroscopy/surgery3510
29897Ankle arthroscopy/surgery3510
29898Ankle arthroscopy/surgery3510
29899A*Ankle arthroscopy/surgery3510
29900Mcp joint arthroscopy, dx3510
29901Mcp joint arthroscopy, surg3510
29902Mcp joint arthroscopy, surg3510
Start Printed Page 15294
30115Removal of nose polyp(s)2446
30117Removal of intranasal lesion3510
30118Removal of intranasal lesion3510
30120Revision of nose1333
30124DRemoval of nose lesion1333
30125Removal of nose lesion2446
30130Removal of turbinate bones3510
30140Removal of turbinate bones2446
30150Partial removal of nose3510
30160Removal of nose4630
30310Remove nasal foreign body1333
30320Remove nasal foreign body2446
30400Reconstruction of nose4630
30410Reconstruction of nose5717
30420Reconstruction of nose5717
30430Revision of nose3510
30435Revision of nose5717
30450Revision of nose7995
30460ARevision of nose7995
30462ARevision of nose91339
30465A*Repair nasal stenosis91339
30520Repair of nasal septum4630
30540Repair nasal defect5717
30545ARepair nasal defect5717
30560Release of nasal adhesions2446
30580Repair upper jaw fistula4630
30600Repair mouth/nose fistula4630
30620Intranasal reconstruction7995
30630Repair nasal septum defect7995
30801Cauterization, inner nose1333
30802Cauterization, inner nose1333
30903Control of nosebleed1333
30905Control of nosebleed1333
30906Repeat control of nosebleed1333
30915Ligation, nasal sinus artery2446
30920Ligation, upper jaw artery3510
30930ATherapy, fracture of nose4630
31020Exploration, maxillary sinus2446
31030Exploration, maxillary sinus3510
31032Explore sinus,remove polyps4630
31050Exploration, sphenoid sinus2446
31051Sphenoid sinus surgery4630
31070Exploration of frontal sinus2446
31075Exploration of frontal sinus4630
31080Removal of frontal sinus4630
31081ARemoval of frontal sinus4630
31084Removal of frontal sinus4630
31085ARemoval of frontal sinus4630
31086Removal of frontal sinus4630
31087ARemoval of frontal sinus4630
31090Exploration of sinuses5717
31200Removal of ethmoid sinus2446
31201Removal of ethmoid sinus5717
31205Removal of ethmoid sinus3510
31233Nasal/sinus endoscopy, dx2446
31235Nasal/sinus endoscopy, dx1333
31237Nasal/sinus endoscopy, surg2446
31238Nasal/sinus endoscopy, surg1333
31239Nasal/sinus endoscopy, surg4630
31240Nasal/sinus endoscopy, surg2446
31254Revision of ethmoid sinus3510
31255Removal of ethmoid sinus5717
31256Exploration maxillary sinus3510
31267Endoscopy, maxillary sinus3510
31276Sinus endoscopy, surgical3510
31287Nasal/sinus endoscopy, surg3510
31288Nasal/sinus endoscopy, surg3510
31300Removal of larynx lesion5717
31320Diagnostic incision, larynx2446
31400ARevision of larynx2446
31420ARemoval of epiglottis2446
31510Laryngoscopy with biopsy2446
Start Printed Page 15295
31511Remove foreign body, larynx2446
31512Removal of larynx lesion2446
31513Injection into vocal cord2446
31515Laryngoscopy for aspiration1333
31525Diagnostic laryngoscopy1333
31526Diagnostic laryngoscopy2446
31527Laryngoscopy for treatment1333
31528Laryngoscopy and dilation2446
31529Laryngoscopy and dilation2446
31530Operative laryngoscopy2446
31531Operative laryngoscopy3510
31535Operative laryngoscopy2446
31536Operative laryngoscopy3510
31540Operative laryngoscopy3510
31541Operative laryngoscopy4630
31560Operative laryngoscopy5717
31561Operative laryngoscopy5717
31570Laryngoscopy with injection2446
31571Laryngoscopy with injection2446
31576Laryngoscopy with biopsy2446
31577Remove foreign body, larynx2446
31578Removal of larynx lesion2446
31580Revision of larynx5717
31582Revision of larynx5717
31584DTreat larynx fracture4630
31585Treat larynx fracture1333
31586Treat larynx fracture2446
31588Revision of larynx5717
31590Reinnervate larynx5717
31595Larynx nerve surgery2446
31600DIncision of windpipe2446
31611Surgery/speech prosthesis3510
31612Puncture/clear windpipe1333
31613Repair windpipe opening2446
31614Repair windpipe opening2446
31615Visualization of windpipe1333
31622Dx bronchoscope/wash1333
31623A*Dx bronchoscope/brush2446
31624A*Dx bronchoscope/lavage2446
31625Bronchoscopy with biopsy2446
31628Bronchoscopy with biopsy2446
31629Bronchoscopy with biopsy2446
31630Bronchoscopy with repair2446
31631Bronchoscopy with dilation2446
31635Remove foreign body, airway2446
31640Bronchoscopy & remove lesion2446
31641Bronchoscopy, treat blockage2446
31643A*Diag bronchoscope/catheter2446
31645Bronchoscopy, clear airways1333
31646Bronchoscopy, reclear airway1333
31656Bronchoscopy, inj for xray1333
31700Insertion of airway catheter1333
31710DInsertion of airway catheter1333
31715DInjection for bronchus x-ray1333
31717Bronchial brush biopsy1333
31720Clearance of airways1333
31730Intro, windpipe wire/tube1333
31750Repair of windpipe5717
31755Repair of windpipe2446
31785DRemove windpipe lesion4630
31800DRepair of windpipe injury2446
31820Closure of windpipe lesion1333
31825Repair of windpipe defect2446
31830Revise windpipe scar2446
32000Drainage of chest1333
32002DTreatment of collapsed lung2446
32005DTreat lung lining chemically2446
32020DInsertion of chest tube2446
32400Needle biopsy chest lining1333
32405Biopsy, lung or mediastinum1333
32420Puncture/clear lung1333
33010Drainage of heart sac2446
Start Printed Page 15296
33011Repeat drainage of heart sac2446
33222ARevise pocket, pacemaker2446
33223ARevise pocket, pacing-defib2446
34101DRemoval of artery clot3510
35188ARepair blood vessel lesion4630
35207ARepair blood vessel lesion4630
35875ARemoval of clot in graft91339
35876ARemoval of clot in graft91339
36260AInsertion of infusion pump3510
36261Revision of infusion pump2446
36262Removal of infusion pump1333
36488AInsertion of catheter, vein1333
36489Insertion of catheter, vein1333
36490AInsertion of catheter, vein1333
36491Insertion of catheter, vein1333
36530Insertion of infusion pump3510
36531Revision of infusion pump2446
36532Removal of infusion pump1333
36533Insertion of access device3510
36534Revision of access device2446
36535Removal of access device1333
36640Insertion catheter, artery1333
36800Insertion of cannula3510
36810Insertion of cannula3510
36815Insertion of cannula3510
36819Av fusion/uppr arm vein91339
36820Av fusion/forearm vein3510
36821Av fusion direct any site3510
36825Artery-vein graft4630
36830Artery-vein graft4630
36831A*Open thrombect av fistula91339
36832Av fistula revision, open4630
36833Av fistula revision4630
36835Artery to vein shunt4630
36860External cannula declotting2446
36861Cannula declotting3510
36870A*Percut thrombect av fistula91339
37607ALigation of a-v fistula3510
37609Temporal artery procedure2446
37650ARevision of major vein2446
37700Revise leg vein2446
37720Removal of leg vein3510
37730Removal of leg veins3510
37735Removal of leg veins/lesion3510
37760Revision of leg veins3510
37780Revision of leg vein3510
37785Revise secondary varicosity3510
37790APenile venous occlusion3510
38300Drainage, lymph node lesion1333
38305Drainage, lymph node lesion2446
38308Incision of lymph channels2446
38500Biopsy/removal, lymph nodes2446
38505Needle biopsy, lymph nodes1333
38510Biopsy/removal, lymph nodes2446
38520Biopsy/removal, lymph nodes2446
38525Biopsy/removal, lymph nodes2446
38530Biopsy/removal, lymph nodes2446
38542Explore deep node(s), neck2446
38550Removal, neck/armpit lesion3510
38555Removal, neck/armpit lesion4630
38570A*Laparoscopy, lymph node biop91339
38571A*Laparoscopy, lymphadenectomy91339
38572A*Laparoscopy, lymphadenectomy91339
38700DRemoval of lymph nodes, neck2446
38740Remove armpit lymph nodes2446
38745Remove armpit lymph nodes4630
38760Remove groin lymph nodes2446
38790DInject for lymphatic x-ray1333
40500Partial excision of lip2446
40510Partial excision of lip2446
40520Partial excision of lip2446
40525Reconstruct lip with flap2446
Start Printed Page 15297
40527Reconstruct lip with flap2446
40530Partial removal of lip2446
40650Repair lip3510
40652Repair lip3510
40654Repair lip3510
40700ARepair cleft lip/nasal7995
40701ARepair cleft lip/nasal7995
40720ARepair cleft lip/nasal7995
40761ARepair cleft lip/nasal3510
40801Drainage of mouth lesion2446
40805DRemoval, foreign body, mouth2446
40806DIncision of lip fold1333
40814Excise/repair mouth lesion2446
40816Excision of mouth lesion2446
40818Excise oral mucosa for graft1333
40819Excise lip or cheek fold1333
40820DTreatment of mouth lesion1333
40831Repair mouth laceration1333
40840Reconstruction of mouth2446
40842Reconstruction of mouth3510
40843Reconstruction of mouth3510
40844Reconstruction of mouth5717
40845Reconstruction of mouth5717
41000DDrainage of mouth lesion1333
41005Drainage of mouth lesion1333
41006Drainage of mouth lesion1333
41007Drainage of mouth lesion1333
41008Drainage of mouth lesion1333
41009Drainage of mouth lesion1333
41010Incision of tongue fold1333
41015Drainage of mouth lesion1333
41016Drainage of mouth lesion1333
41017Drainage of mouth lesion1333
41018Drainage of mouth lesion1333
41105DBiopsy of tongue2446
41110DExcision of tongue lesion1333
41112Excision of tongue lesion2446
41113Excision of tongue lesion2446
41114Excision of tongue lesion2446
41115DExcision of tongue fold1333
41116Excision of mouth lesion1333
41120Partial removal of tongue5717
41250Repair tongue laceration2446
41251Repair tongue laceration2446
41252Repair tongue laceration2446
41500Fixation of tongue1333
41510Tongue to lip surgery1333
41520Reconstruction, tongue fold2446
41800Drainage of gum lesion1333
41805DRemoval foreign body, gum1333
41806DRemoval foreign body, jawbone1333
41827Excision of gum lesion2446
42000Drainage mouth roof lesion2446
42104DExcision lesion, mouth roof2446
42106DExcision lesion, mouth roof2446
42107Excision lesion, mouth roof2446
42120Remove palate/lesion4630
42140Excision of uvula2446
42145Repair palate, pharynx/uvula5717
42160DTreatment mouth roof lesion1333
42180Repair palate1333
42182Repair palate2446
42200Reconstruct cleft palate5717
42205Reconstruct cleft palate5717
42210Reconstruct cleft palate5717
42215Reconstruct cleft palate7995
42220Reconstruct cleft palate5717
42225DReconstruct cleft palate5717
42226ALengthening of palate5717
42235Repair palate5717
42260Repair nose to lip fistula4630
42281DInsertion, palate prosthesis3510
Start Printed Page 15298
42300Drainage of salivary gland1333
42305Drainage of salivary gland2446
42310Drainage of salivary gland1333
42320Drainage of salivary gland1333
42325Create salivary cyst drain2446
42335DRemoval of salivary stone3510
42340Removal of salivary stone2446
42405Biopsy of salivary gland2446
42408Excision of salivary cyst3510
42409Drainage of salivary cyst3510
42410Excise parotid gland/lesion3510
42415AExcise parotid gland/lesion3510
42420Excise parotid gland/lesion7995
42425Excise parotid gland/lesion7995
42440Excise submaxillary gland3510
42450Excise sublingual gland2446
42500Repair salivary duct3510
42505Repair salivary duct4630
42507Parotid duct diversion3510
42508Parotid duct diversion4630
42509Parotid duct diversion4630
42510Parotid duct diversion4630
42600Closure of salivary fistula1333
42700Drainage of tonsil abscess1333
42720Drainage of throat abscess1333
42725Drainage of throat abscess2446
42802Biopsy of throat1333
42804Biopsy of upper nose/throat1333
42806Biopsy of upper nose/throat2446
42808Excise pharynx lesion2446
42810Excision of neck cyst3510
42815Excision of neck cyst5717
42820ARemove tonsils and adenoids3510
42821Remove tonsils and adenoids5717
42825ARemoval of tonsils4630
42826Removal of tonsils4630
42830ARemoval of adenoids4630
42831Removal of adenoids4630
42835ARemoval of adenoids4630
42836Removal of adenoids4630
42860Excision of tonsil tags3510
42870Excision of lingual tonsil3510
42890APartial removal of pharynx7995
42892ARevision of pharyngeal walls7995
42900Repair throat wound1333
42950Reconstruction of throat2446
42955Surgical opening of throat2446
42960Control throat bleeding1333
42962Control throat bleeding2446
42972AControl nose/throat bleeding3510
43200Esophagus endoscopy1333
43201A*Esoph scope w/submucous inj1333
43202Esophagus endoscopy, biopsy1333
43204Esophagus endoscopy & inject1333
43205AEsophagus endoscopy/ligation1333
43215Esophagus endoscopy1333
43216Esophagus endoscopy/lesion1333
43217Esophagus endoscopy1333
43219Esophagus endoscopy1333
43220Esoph endoscopy, dilation1333
43226Esoph endoscopy, dilation1333
43227Esoph endoscopy, repair2446
43228Esoph endoscopy, ablation2446
43231A*Esoph endoscopy w/us exam2446
43232A*Esoph endoscopy w/us fn bx2446
43234Upper GI endoscopy, exam1333
43235Uppr gi endoscopy, diagnosis1333
43236A*Uppr gi scope w/submuc inj2446
43239Upper GI endoscopy, biopsy2446
43240A*Esoph endoscope w/drain cyst2446
43241Upper GI endoscopy with tube2446
43242A*Uppr gi endoscopy w/us fn bx2446
Start Printed Page 15299
43243Upper gi endoscopy & inject2446
43244AUpper GI endoscopy/ligation2446
43245Operative upper GI endoscopy2446
43246Place gastrostomy tube2446
43247Operative upper GI endoscopy2446
43248Uppr gi endoscopy/guide wire2446
43249Esoph endoscopy, dilation2446
43250Upper GI endoscopy/tumor2446
43251Operative upper GI endoscopy2446
43255Operative upper GI endoscopy2446
43256A*Uppr gi endoscopy w stent3510
43258Operative upper GI endoscopy3510
43259Endoscopic ultrasound exam3510
43260Endo cholangiopancreatograph2446
43261Endo cholangiopancreatograph2446
43262Endo cholangiopancreatograph2446
43263Endo cholangiopancreatograph2446
43264Endo cholangiopancreatograph2446
43265Endo cholangiopancreatograph2446
43267Endo cholangiopancreatograph2446
43268Endo cholangiopancreatograph2446
43269Endo cholangiopancreatograph2446
43271Endo cholangiopancreatograph2446
43272Endo cholangiopancreatograph2446
43450Dilate esophagus1333
43453Dilate esophagus1333
43456Dilate esophagus2446
43458Dilate esophagus2446
43600Biopsy of stomach1333
43653A*Laparoscopy, gastrostomy91339
43750Place gastrostomy tube2446
43760Change gastrostomy tube1333
43870Repair stomach opening1333
44100Biopsy of bowel1333
44312Revision of ileostomy1333
44340Revision of colostomy3510
44345DRevision of colostomy4630
44346DRevision of colostomy4630
44360Small bowel endoscopy2446
44361Small bowel endoscopy/biopsy2446
44363Small bowel endoscopy2446
44364Small bowel endoscopy2446
44365Small bowel endoscopy2446
44366Small bowel endoscopy2446
44369Small bowel endoscopy2446
44370A*Small bowel endoscopy/stent91339
44372Small bowel endoscopy2446
44373Small bowel endoscopy2446
44376ASmall bowel endoscopy2446
44377ASmall bowel endoscopy/biopsy2446
44378ASmall bowel endoscopy2446
44379A*S bowel endoscope w/stent91339
44380Small bowel endoscopy1333
44382Small bowel endoscopy1333
44383A*Ileoscopy w/stent91339
44385Endoscopy of bowel pouch1333
44386Endoscopy, bowel pouch/biop1333
44388Colon endoscopy1333
44389Colonoscopy with biopsy1333
44390Colonoscopy for foreign body1333
44391Colonoscopy for bleeding1333
44392Colonoscopy & polypectomy1333
44393Colonoscopy, lesion removal1333
44394Colonoscopy w/snare1333
45000Drainage of pelvic abscess1333
45005Drainage of rectal abscess2446
45020Drainage of rectal abscess2446
45100Biopsy of rectum1333
45108Removal of anorectal lesion2446
45150Excision of rectal stricture2446
45160AExcision of rectal lesion2446
45170Excision of rectal lesion2446
Start Printed Page 15300
45190ADestruction, rectal tumor91339
45305Protosigmoidoscopy w/bx1333
45307Protosigmoidoscopy fb1333
45308Protosigmoidoscopy removal1333
45309Protosigmoidoscopy removal1333
45315Protosigmoidoscopy removal1333
45317Protosigmoidoscopy bleed1333
45320Protosigmoidoscopy ablate1333
45321Protosigmoidoscopy volvul1333
45331Sigmoidoscopy and biopsy1333
45332Sigmoidoscopy w/fb removal1333
45333Sigmoidoscopy & polypectomy1333
45334Sigmoidoscopy for bleeding1333
45335A*Sigmoidoscope w/submub inj1333
45337Sigmoidoscopy & decompress1333
45338Sigmoidoscpy w/tumr remove1333
45339Sigmoidoscopy w/ablate tumr1333
45340A*Sig w/balloon dilation1333
45355Surgical colonoscopy1333
45378Diagnostic colonoscopy2446
45379Colonoscopy w/fb removal2446
45380Colonoscopy and biopsy2446
45381A*Colonoscope, submucous inj2446
45382Colonoscopy/control bleeding2446
45383Lesion removal colonoscopy2446
45384Lesion remove colonoscopy2446
45385Lesion removal colonoscopy2446
45386A*Colonoscope dilate stricture2446
45500Repair of rectum2446
45505Repair of rectum2446
45560Repair of rectocele2446
45900Reduction of rectal prolapse1333
45905Dilation of anal sphincter1333
45910Dilation of rectal narrowing1333
45915Remove rectal obstruction1333
46020Placement of seton3510
46030Removal of rectal marker1333
46040Incision of rectal abscess3510
46045Incision of rectal abscess2446
46050Incision of anal abscess1333
46060Incision of rectal abscess2446
46080Incision of anal sphincter3510
46200Removal of anal fissure2446
46210Removal of anal crypt2446
46211Removal of anal crypts2446
46220Removal of anal tab1333
46250Hemorrhoidectomy3510
46255Hemorrhoidectomy3510
46257Remove hemorrhoids & fissure3510
46258Remove hemorrhoids & fistula3510
46260Hemorrhoidectomy3510
46261Remove hemorrhoids & fissure4630
46262Remove hemorrhoids & fistula4630
46270Removal of anal fistula3510
46275Removal of anal fistula3510
46280Removal of anal fistula4630
46285Removal of anal fistula1333
46288ARepair anal fistula4630
46608Anoscopy/remove for body1333
46610Anoscopy/remove lesion1333
46611Anoscopy1333
46612Anoscopy/remove lesions1333
46615AAnoscopy2446
46700Repair of anal stricture3510
46750Repair of anal sphincter3510
46753Reconstruction of anus3510
46754Removal of suture from anus2446
46760Repair of anal sphincter2446
46761ARepair of anal sphincter3510
46762AImplant artificial sphincter7995
46917ALaser surgery, anal lesions1333
46922Excision of anal lesion(s)1333
Start Printed Page 15301
46924Destruction, anal lesion(s)1333
46937Cryotherapy of rectal lesion2446
46938Cryotherapy of rectal lesion2446
47000Needle biopsy of liver1333
47510Insert catheter, bile duct2446
47511AInsert bile duct drain91339
47525Change bile duct catheter1333
47530Revise/reinsert bile tube1333
47552Biliary endoscopy thru skin2446
47553Biliary endoscopy thru skin3510
47554Biliary endoscopy thru skin3510
47555Biliary endoscopy thru skin3510
47556ABiliary endoscopy thru skin91339
47560Laparoscopy w/cholangio3510
47561Laparo w/cholangio/biopsy3510
47630Remove bile duct stone3510
48102Needle biopsy, pancreas1333
49000DExploration of abdomen4630
49080Puncture, peritoneal cavity2446
49081Removal of abdominal fluid2446
49085Remove abdomen foreign body2446
49180Biopsy, abdominal mass1333
49250Excision of umbilicus4630
49320Diag laparo separate proc3510
49321Laparoscopy, biopsy4630
49322Laparoscopy, aspiration4630
49400DAir injection into abdomen1333
49420Insert abdominal drain1333
49421Insert abdominal drain1333
49422ARemove perm cannula/catheter1333
49425DInsert abdomen-venous drain2446
49426Revise abdomen-venous shunt2446
49495ARpr ing hernia baby, reduc4630
49496ARpr ing hernia baby, blocked4630
49500ARpr ing hernia, init, reduce4630
49501ARpr ing hernia, init blocked91339
49505Rpr i/hern init reduc>5 yr4630
49507ARpr i/hern init block>5 yr91339
49520Rerepair ing hernia, reduce7995
49521ARerepair ing hernia, blocked91339
49525Repair ing hernia, sliding4630
49540Repair lumbar hernia2446
49550Rpr fem hernia, init, reduce5717
49553ARpr fem hernia, init blocked91339
49555Rerepair fem hernia, reduce5717
49557ARerepair fem hernia, blocked91339
49560Rpr ventral hern init, reduc4630
49561ARpr ventral hern init, block91339
49565Rerepair ventrl hern, reduce4630
49566ARerepair ventrl hern, block91339
49568AHernia repair w/mesh7995
49570Rpr epigastric hern, reduce4630
49572ARpr epigastric hern, blocked91339
49580ARpr umbil hern, reduc <5 yr4630
49582ARpr umbil hern, block < 5 yr91339
49585Rpr umbil hern, reduc > 5 yr4630
49587ARpr umbil hern, block > 5 yr91339
49590Repair spigelian hernia3510
49600ARepair umbilical lesion4630
49650Laparo hernia repair initial4630
49651Laparo hernia repair recur7995
50020DRenal abscess, open drain2446
50040DDrainage of kidney3510
50200Biopsy of kidney1333
50390Drainage of kidney lesion1333
50392Insert kidney drain1333
50393Insert ureteral tube1333
50395Create passage to kidney1333
50396Measure kidney pressure1333
50398Change kidney tube1333
50520DClose kidney-skin fistula1333
50551Kidney endoscopy1333
Start Printed Page 15302
50553Kidney endoscopy1333
50555Kidney endoscopy & biopsy1333
50557Kidney endoscopy & treatment1333
50559Renal endoscopy/radiotracer1333
50561Kidney endoscopy & treatment1333
50570DKidney endoscopy1333
50572DKidney endoscopy1333
50574DKidney endoscopy & biopsy1333
50576DKidney endoscopy & treatment1333
50578DRenal endoscopy/radiotracer1333
50580DKidney endoscopy & treatment1333
50684DInjection for ureter x-ray1333
50688Change of ureter tube1333
50690DInjection for ureter x-ray1333
50947A*Laparo new ureter/bladder91339
50948A*Laparo new ureter/bladder91339
50951Endoscopy of ureter1333
50953Endoscopy of ureter1333
50955Ureter endoscopy & biopsy1333
50957Ureter endoscopy & treatment1333
50959Ureter endoscopy & tracer1333
50961Ureter endoscopy & treatment1333
50970Ureter endoscopy1333
50972Ureter endoscopy & catheter1333
50974Ureter endoscopy & biopsy1333
50976Ureter endoscopy & treatment1333
50978Ureter endoscopy & tracer1333
50980Ureter endoscopy & treatment1333
51005DDrainage of bladder1333
51010Drainage of bladder1333
51020Incise & treat bladder4630
51030Incise & treat bladder4630
51040Incise & drain bladder4630
51045Incise bladder/drain ureter4630
51050ARemoval of bladder stone4630
51065ARemove ureter calculus4630
51080ADrainage of bladder abscess1333
51500Removal of bladder cyst4630
51520ARemoval of bladder lesion4630
51600DInjection for bladder x-ray1333
51605DPreparation for bladder xray1333
51610DInjection for bladder x-ray1333
51710Change of bladder tube1333
51715AEndoscopic injection/implant3510
51725DSimple cystometrogram1333
51726Complex cystometrogram1333
51772Urethra pressure profile1333
51785Anal/urinary muscle study1333
51865DRepair of bladder wound4630
51880Repair of bladder opening1333
51900DRepair bladder/vagina lesion4630
51920DClose bladder-uterus fistula3510
52000Cystoscopy1333
52001Cystoscopy, removal of clots2446
52005Cystoscopy & ureter catheter2446
52007Cystoscopy and biopsy2446
52010Cystoscopy & duct catheter2446
52204Cystoscopy2446
52214Cystoscopy and treatment2446
52224Cystoscopy and treatment2446
52234Cystoscopy and treatment2446
52235Cystoscopy and treatment3510
52240Cystoscopy and treatment3510
52250Cystoscopy and radiotracer4630
52260Cystoscopy and treatment2446
52270Cystoscopy & revise urethra2446
52275Cystoscopy & revise urethra2446
52276Cystoscopy and treatment3510
52277Cystoscopy and treatment2446
52281Cystoscopy and treatment2446
52282ACystoscopy, implant stent91339
52283Cystoscopy and treatment2446
Start Printed Page 15303
52285Cystoscopy and treatment2446
52290Cystoscopy and treatment2446
52300Cystoscopy and treatment2446
52305Cystoscopy and treatment2446
52310Cystoscopy and treatment2446
52315Cystoscopy and treatment2446
52317Remove bladder stone1333
52318Remove bladder stone2446
52320Cystoscopy and treatment5717
52325Cystoscopy, stone removal4630
52327ACystoscopy, inject material2446
52330Cystoscopy and treatment2446
52332Cystoscopy and treatment2446
52334Create passage to kidney3510
52341A*Cysto w/ureter stricture tx3510
52342A*Cysto w/up stricture tx3510
52343A*Cysto w/renal stricture tx3510
52344A*Cysto/uretero, stone remove3510
52345A*Cysto/uretero w/up stricture3510
52346A*Cystouretero w/renal strict3510
52351Cystouretro & or pyeloscope3510
52352Cystouretro w/stone remove4630
52353Cystouretero w/lithotripsy4630
52354Cystouretero w/biopsy4630
52355ACystouretero w/excise tumor4630
52400Cystouretero w/congen repr3510
52450Incision of prostate3510
52500Revision of bladder neck3510
52510ADilation prostatic urethra3510
52601Prostatectomy (TURP)4630
52606Control postop bleeding1333
52612Prostatectomy, first stage2446
52614Prostatectomy, second stage1333
52620Remove residual prostate1333
52630Remove prostate regrowth2446
52640Relieve bladder contracture2446
52647ALaser surgery of prostate91339
52648ALaser surgery of prostate91339
52700Drainage of prostate abscess2446
53000Incision of urethra1333
53010Incision of urethra1333
53020Incision of urethra1333
53040Drainage of urethra abscess2446
53080ADrainage of urinary leakage3510
53200Biopsy of urethra1333
53210Removal of urethra5717
53215Removal of urethra5717
53220Treatment of urethra lesion2446
53230Removal of urethra lesion2446
53235Removal of urethra lesion3510
53240Surgery for urethra pouch2446
53250Removal of urethra gland2446
53260Treatment of urethra lesion2446
53265Treatment of urethra lesion2446
53270ARemoval of urethra gland2446
53275Repair of urethra defect2446
53400Revise urethra, stage 13510
53405Revise urethra, stage 22446
53410Reconstruction of urethra2446
53420Reconstruct urethra, stage 13510
53425Reconstruct urethra, stage 22446
53430Reconstruction of urethra2446
53431Reconstruct urethra/bladder2446
53440Correct bladder function2446
53442Remove perineal prosthesis1333
53444Insert tandem cuff2446
53445Insert uro/ves nck sphincter1333
53446Remove uro sphincter1333
53447Remove/replace ur sphincter1333
53449Repair uro sphincter1333
53450Revision of urethra1333
53460Revision of urethra1333
Start Printed Page 15304
53502Repair of urethra injury2446
53505Repair of urethra injury2446
53510Repair of urethra injury2446
53515Repair of urethra injury2446
53520Repair of urethra defect2446
53605Dilate urethra stricture2446
53665Dilation of urethra1333
53850AProstatic microwave thermotx91339
54000ASlitting of prepuce2446
54001Slitting of prepuce2446
54015Drain penis lesion4630
54057Laser surg, penis lesion(s)1333
54060Excision of penis lesion(s)1333
54065Destruction, penis lesion(s)1333
54100Biopsy of penis1333
54105Biopsy of penis1333
54110Treatment of penis lesion2446
54111ATreat penis lesion, graft2446
54112ATreat penis lesion, graft2446
54115Treatment of penis lesion1333
54120Partial removal of penis2446
54125DRemoval of penis2446
54150ACircumcision1333
54152Circumcision1333
54160ACircumcision2446
54161Circumcision2446
54162Lysis penil circumcis lesion2446
54163Repair of circumcision2446
54164Frenulotomy of penis2446
54205Treatment of penis lesion4630
54220Treatment of penis lesion1333
54300Revision of penis3510
54304ARevision of penis3510
54308AReconstruction of urethra3510
54312AReconstruction of urethra3510
54316AReconstruction of urethra3510
54318AReconstruction of urethra3510
54322AReconstruction of urethra3510
54324AReconstruction of urethra3510
54326AReconstruction of urethra3510
54328ARevise penis/urethra3510
54340ASecondary urethral surgery3510
54344ASecondary urethral surgery3510
54348ASecondary urethral surgery3510
54352AReconstruct urethra/penis3510
54360Penis plastic surgery3510
54380ARepair penis3510
54385ARepair penis3510
54400AInsert semi-rigid prosthesis3510
54401AInsert self-contd prosthesis3510
54405AInsert multi-comp penis pros3510
54406ARemove multi-comp penis pros3510
54408ARepair multi-comp penis pros3510
54410ARemove/replace penis prosth3510
54415ARemove self-contd penis pros3510
54416ARemv/repl penis contain pros3510
54420Revision of penis4630
54435Revision of penis4630
54440Repair of penis4630
54450Preputial stretching1333
54500Biopsy of testis1333
54505Biopsy of testis1333
54512Excise lesion testis7995
54520Removal of testis3510
54522AOrchiectomy, partial3510
54530Removal of testis4630
54550Exploration for testis4630
54600Reduce testis torsion4630
54620Suspension of testis3510
54640Suspension of testis4630
54660Revision of testis2446
54670Repair testis injury3510
Start Printed Page 15305
54680Relocation of testis(es)3510
54690A*Laparoscopy, orchiectomy91339
54700Drainage of scrotum2446
54800Biopsy of epididymis1333
54820Exploration of epididymis1333
54830Remove epididymis lesion3510
54840Remove epididymis lesion4630
54860Removal of epididymis3510
54861Removal of epididymis4630
54900Fusion of spermatic ducts4630
54901Fusion of spermatic ducts4630
55040Removal of hydrocele3510
55041Removal of hydroceles5717
55060Repair of hydrocele4630
55100Drainage of scrotum abscess1333
55110Explore scrotum2446
55120Removal of scrotum lesion2446
55150Removal of scrotum1333
55175Revision of scrotum1333
55180Revision of scrotum2446
55200Incision of sperm duct2446
55250ARemoval of sperm duct(s)2446
55400Repair of sperm duct1333
55500Removal of hydrocele3510
55520Removal of sperm cord lesion4630
55530Revise spermatic cord veins4630
55535Revise spermatic cord veins4630
55540Revise hernia & sperm veins5717
55550ALaparo ligate spermatic vein91339
55600DIncise sperm duct pouch1333
55605DIncise sperm duct pouch1333
55650DRemove sperm duct pouch1333
55680Remove sperm pouch lesion1333
55700Biopsy of prostate2446
55705Biopsy of prostate2446
55720Drainage of prostate abscess1333
55725ADrainage of prostate abscess2446
55859APercut/needle insert, pros91339
56405DI & D of vulva/perineum2446
56440Surgery for vulva lesion2446
56441Lysis of labial lesion(s)1333
56515Destroy vulva lesion/s compl3510
56605DBiopsy of vulva/perineum1333
56620Partial removal of vulva5717
56625Complete removal of vulva7995
56700Partial removal of hymen1333
56720Incision of hymen1333
56740Remove vagina gland lesion3510
56800Repair of vagina3510
56810Repair of perineum5717
57000Exploration of vagina1333
57010Drainage of pelvic abscess2446
57020Drainage of pelvic fluid2446
57023A*I & d vag hematoma, non-ob1333
57065Destroy vag lesions, complex1333
57105Biopsy of vagina2446
57130Remove vagina lesion2446
57135Remove vagina lesion2446
57180Treat vaginal bleeding1333
57200Repair of vagina1333
57210Repair vagina/perineum2446
57220Revision of urethra3510
57230Repair of urethral lesion3510
57240Repair bladder & vagina5717
57250Repair rectum & vagina5717
57260Repair of vagina5717
57265Extensive repair of vagina7995
57268Repair of bowel bulge3510
57289ARepair bladder & vagina5717
57291AConstruction of vagina5717
57300Repair rectum-vagina fistula3510
57310DRepair urethrovaginal lesion3510
Start Printed Page 15306
57311DRepair urethrovaginal lesion4630
57320DRepair bladder-vagina lesion3510
57400Dilation of vagina2446
57410Pelvic examination2446
57415ARemove vaginal foreign body2446
57513Laser surgery of cervix2446
57520Conization of cervix2446
57522Conization of cervix2446
57530Removal of cervix3510
57550Removal of residual cervix3510
57556ARemove cervix, repair bowel5717
57700Revision of cervix1333
57720Revision of cervix3510
57800DDilation of cervical canal1333
57820D & c of residual cervix3510
58120Dilation and curettage2446
58145Removal of uterus lesion5717
58350AReopen fallopian tube3510
58353Endometr ablate, thermal4630
58545ALaparoscopic myomectomy91339
58546A*Laparo-myomectomy, complex91339
58550A*Laparo-asst vag hysterectomy91339
58551DLaparoscopy, remove myoma5717
58555Hysteroscopy, dx, sep proc1333
58558Hysteroscopy, biopsy3510
58559Hysteroscopy, lysis2446
58560A*Hysteroscopy, resect septum3510
58561Hysteroscopy, remove myoma3510
58562A*Hysteroscopy, remove fb3510
58563Hysteroscopy, ablation4630
58660Laparoscopy, lysis5717
58661Laparoscopy, remove adnexa5717
58662Laparoscopy, excise lesions5717
58670Laparoscopy, tubal cautery3510
58671Laparoscopy, tubal block3510
58672Laparoscopy, fimbrioplasty5717
58673Laparoscopy, salpingostomy5717
58800Drainage of ovarian cyst(s)3510
58820Drain ovary abscess, open3510
58900Biopsy of ovary(s)3510
59160AD & c after delivery3510
59320ARevision of cervix1333
59812ATreatment of miscarriage5717
59820ACare of miscarriage5717
59821ATreatment of miscarriage5717
59840AAbortion5717
59841AAbortion5717
59870AEvacuate mole of uterus5717
59871ARemove cerclage suture5717
60000Drain thyroid/tongue cyst1333
60200Remove thyroid lesion2446
60220DPartial removal of thyroid2446
60225DPartial removal of thyroid3510
60280Remove thyroid duct lesion4630
60281Remove thyroid duct lesion4630
61020Remove brain cavity fluid1333
61026Injection into brain canal1333
61050Remove brain canal fluid1333
61055Injection into brain canal1333
61070Brain canal shunt procedure1333
61215Insert brain-fluid device3510
61790Treat trigeminal nerve3510
61791Treat trigeminal tract3510
61885Implant neurostim one array2446
61886A*Implant neurostim arrays3510
61888Revise/remove neuroreceiver1333
62194Replace/irrigate catheter1333
62225Replace/irrigate catheter1333
62230Replace/revise brain shunt2446
62256DRemove brain cavity shunt2446
62263Lysis epidural adhesions1333
62268Drain spinal cord cyst1333
Start Printed Page 15307
62269Needle biopsy, spinal cord1333
62270Spinal fluid tap, diagnostic1333
62272Drain cerebro spinal fluid1333
62273Treat epidural spine lesion1333
62280Treat spinal cord lesion1333
62281ATreat spinal cord lesion1333
62282Treat spinal canal lesion1333
62287APercutaneous diskectomy91339
62294Injection into spinal artery3510
62310Inject spine c/t1333
62311Inject spine l/s (cd)1333
62318Inject spine w/cath, c/t1333
62319Inject spine w/cath l/s (cd)1333
62350Implant spinal canal cath2446
62351DImplant spinal canal cath2446
62355ARemove spinal canal catheter2446
62360Insert spine infusion device2446
62361Implant spine infusion pump2446
62362Implant spine infusion pump2446
62365Remove spine infusion device2446
62367DAnalyze spine infusion pump2446
62368DAnalyze spine infusion pump2446
63600Remove spinal cord lesion2446
63610Stimulation of spinal cord1333
63650Implant neuroelectrodes2446
63660Revise/remove neuroelectrode1333
63685Implant neuroreceiver2446
63688Revise/remove neuroreceiver1333
63744Revision of spinal shunt3510
63746Removal of spinal shunt2446
64410Injection for nerve block1333
64415Injection for nerve block1333
64417Injection for nerve block1333
64420Injection for nerve block1333
64421Injection for nerve block1333
64430Injection for nerve block1333
64470Inj paravertebral c/t1333
64472Inj paravertebral c/t add-on1333
64475Inj paravertebral l/s1333
64476Inj paravertebral l/s add-on1333
64479Inj foramen epidural c/t1333
64480Inj foramen epidural add-on1333
64483Inj foramen epidural l/s1333
64484Inj foramen epidural add-on1333
64510Injection for nerve block1333
64520Injection for nerve block1333
64530Injection for nerve block1333
64553AImplant neuroelectrodes1333
64573AImplant neuroelectrodes1333
64575Implant neuroelectrodes1333
64577AImplant neuroelectrodes1333
64580AImplant neuroelectrodes1333
64585ARevise/remove neuroelectrode1333
64590Implant neuroreceiver2446
64595Revise/remove neuroreceiver1333
64600Injection treatment of nerve1333
64605Injection treatment of nerve1333
64610Injection treatment of nerve1333
64620Injection treatment of nerve1333
64622Destr paravertebrl nerve l/s1333
64623Destr paravertebral n add-on1333
64626Destr paravertebrl nerve c/t1333
64627Destr paravertebral n add-on1333
64630Injection treatment of nerve2446
64680Injection treatment of nerve2446
64702Revise finger/toe nerve1333
64704Revise hand/foot nerve1333
64708Revise arm/leg nerve2446
64712Revision of sciatic nerve2446
64713Revision of arm nerve(s)2446
64714Revise low back nerve(s)2446
64716Revision of cranial nerve3510
Start Printed Page 15308
64718Revise ulnar nerve at elbow2446
64719Revise ulnar nerve at wrist2446
64721Carpal tunnel surgery2446
64722Relieve pressure on nerve(s)1333
64726Release foot/toe nerve1333
64727Internal nerve revision1333
64732Incision of brow nerve2446
64734Incision of cheek nerve2446
64736Incision of chin nerve2446
64738Incision of jaw nerve2446
64740Incision of tongue nerve2446
64742Incision of facial nerve2446
64744Incise nerve, back of head2446
64746Incise diaphragm nerve2446
64771Sever cranial nerve2446
64772Incision of spinal nerve2446
64774Remove skin nerve lesion2446
64776Remove digit nerve lesion3510
64778Digit nerve surgery add-on2446
64782Remove limb nerve lesion3510
64783Limb nerve surgery add-on2446
64784Remove nerve lesion3510
64786Remove sciatic nerve lesion3510
64787Implant nerve end2446
64788Remove skin nerve lesion3510
64790Removal of nerve lesion3510
64792Removal of nerve lesion3510
64795Biopsy of nerve2446
64802Remove sympathetic nerves2446
64821A*Remove sympathetic nerves4630
64831Repair of digit nerve4630
64832Repair nerve add-on1333
64834Repair of hand or foot nerve2446
64835Repair of hand or foot nerve3510
64836Repair of hand or foot nerve3510
64837Repair nerve add-on1333
64840Repair of leg nerve2446
64856Repair/transpose nerve2446
64857Repair arm/leg nerve2446
64858Repair sciatic nerve2446
64859Nerve surgery1333
64861Repair of arm nerves3510
64862Repair of low back nerves3510
64864Repair of facial nerve3510
64865Repair of facial nerve4630
64870Fusion of facial/other nerve4630
64872Subsequent repair of nerve2446
64874Repair & revise nerve add-on3510
64876Repair nerve/shorten bone3510
64885ANerve graft, head or neck2446
64886ANerve graft, head or neck2446
64890Nerve graft, hand or foot2446
64891Nerve graft, hand or foot2446
64892Nerve graft, arm or leg2446
64893Nerve graft, arm or leg2446
64895Nerve graft, hand or foot3510
64896Nerve graft, hand or foot3510
64897Nerve graft, arm or leg3510
64898Nerve graft, arm or leg3510
64901Nerve graft add-on2446
64902Nerve graft add-on2446
64905Nerve pedicle transfer2446
64907Nerve pedicle transfer1333
65091Revise eye3510
65093Revise eye with implant3510
65101Removal of eye3510
65103Remove eye/insert implant3510
65105Remove eye/attach implant4630
65110Removal of eye5717
65112Remove eye/revise socket7995
65114Remove eye/revise socket7995
65130Insert ocular implant3510
Start Printed Page 15309
65135Insert ocular implant2446
65140Attach ocular implant3510
65150Revise ocular implant2446
65155Reinsert ocular implant3510
65175Removal of ocular implant1333
65235Remove foreign body from eye2446
65260Remove foreign body from eye3510
65265Remove foreign body from eye4630
65270Repair of eye wound2446
65272Repair of eye wound2446
65275Repair of eye wound4630
65280Repair of eye wound4630
65285Repair of eye wound4630
65290Repair of eye socket wound3510
65400Removal of eye lesion1333
65410Biopsy of cornea2446
65420Removal of eye lesion2446
65426Removal of eye lesion5717
65710Corneal transplant7995
65730Corneal transplant7995
65750Corneal transplant7995
65755Corneal transplant7995
65770Revise cornea with implant7995
65772ACorrection of astigmatism4630
65775ACorrection of astigmatism4630
65800Drainage of eye1333
65805Drainage of eye1333
65810Drainage of eye3510
65815Drainage of eye2446
65850Incision of eye4630
65865Incise inner eye adhesions1333
65870Incise inner eye adhesions4630
65875Incise inner eye adhesions4630
65880Incise inner eye adhesions4630
65900Remove eye lesion5717
65920Remove implant of eye7995
65930Remove blood clot from eye5717
66020Injection treatment of eye1333
66030Injection treatment of eye1333
66130Remove eye lesion7995
66150Glaucoma surgery4630
66155Glaucoma surgery4630
66160Glaucoma surgery2446
66165Glaucoma surgery4630
66170Glaucoma surgery4630
66172Incision of eye4630
66180Implant eye shunt5717
66185Revise eye shunt2446
66220Repair eye lesion3510
66225Repair/graft eye lesion4630
66250Follow-up surgery of eye2446
66500Incision of iris1333
66505Incision of iris1333
66600Remove iris and lesion3510
66605Removal of iris3510
66625Removal of iris3510
66630Removal of iris3510
66635Removal of iris3510
66680Repair iris & ciliary body3510
66682Repair iris & ciliary body2446
66700Destruction, ciliary body2446
66710Destruction, ciliary body2446
66720Destruction, ciliary body2446
66740Destruction, ciliary body2446
66821After cataract laser surgery2446
66825AReposition intraocular lens4630
66830Removal of lens lesion4630
66840Removal of lens material4630
66850Removal of lens material7995
66852Removal of lens material4630
66920Extraction of lens4630
66930Extraction of lens5717
Start Printed Page 15310
66940Extraction of lens5717
66982Cataract surgery, complex8973
66983Cataract surg w/iol, 1 stage8973
66984Cataract surg w/iol, i stage8973
66985Insert lens prosthesis6826
66986Exchange lens prosthesis6826
67005Partial removal of eye fluid4630
67010Partial removal of eye fluid4630
67015Release of eye fluid1333
67025Replace eye fluid1333
67027AImplant eye drug system4630
67030Incise inner eye strands1333
67031Laser surgery, eye strands2446
67036Removal of inner eye fluid4630
67038Strip retinal membrane5717
67039Laser treatment of retina7995
67040Laser treatment of retina7995
67107Repair detached retina5717
67108Repair detached retina7995
67112Rerepair detached retina7995
67115Release encircling material2446
67120Remove eye implant material2446
67121Remove eye implant material2446
67141Treatment of retina2446
67218Treatment of retinal lesion5717
67227Treatment of retinal lesion1333
67250Reinforce eye wall3510
67255Reinforce/graft eye wall3510
67311Revise eye muscle3510
67312Revise two eye muscles4630
67314Revise eye muscle4630
67316Revise two eye muscles4630
67318Revise eye muscle(s)4630
67320Revise eye muscle(s) add-on4630
67331Eye surgery follow-up add-on4630
67332Rerevise eye muscles add-on4630
67334ARevise eye muscle w/suture4630
67335AEye suture during surgery4630
67340Revise eye muscle add-on4630
67350Biopsy eye muscle1333
67400Explore/biopsy eye socket3510
67405Explore/drain eye socket4630
67412Explore/treat eye socket5717
67413Explore/treat eye socket5717
67415Aspiration, orbital contents1333
67420Explore/treat eye socket5717
67430Explore/treat eye socket5717
67440Explore/drain eye socket5717
67450Explore/biopsy eye socket5717
67550Insert eye socket implant4630
67560Revise eye socket implant2446
67715Incision of eyelid fold1333
67808Remove eyelid lesion(s)2446
67830Revise eyelashes2446
67835Revise eyelashes2446
67880Revision of eyelid3510
67882Revision of eyelid3510
67900ARepair brow defect4630
67901Repair eyelid defect5717
67902Repair eyelid defect5717
67903Repair eyelid defect4630
67904Repair eyelid defect4630
67906Repair eyelid defect5717
67908Repair eyelid defect4630
67909Revise eyelid defect4630
67911Revise eyelid defect3510
67914Repair eyelid defect3510
67916Repair eyelid defect4630
67917Repair eyelid defect4630
67921Repair eyelid defect3510
67923Repair eyelid defect4630
67924Repair eyelid defect4630
Start Printed Page 15311
67935Repair eyelid wound2446
67950Revision of eyelid2446
67961Revision of eyelid3510
67966Revision of eyelid3510
67971Reconstruction of eyelid3510
67973Reconstruction of eyelid3510
67974Reconstruction of eyelid3510
67975Reconstruction of eyelid3510
68115ARemove eyelid lining lesion2446
68130Remove eyelid lining lesion2446
68320Revise/graft eyelid lining4630
68325Revise/graft eyelid lining4630
68326Revise/graft eyelid lining4630
68328Revise/graft eyelid lining4630
68330Revise eyelid lining4630
68335Revise/graft eyelid lining4630
68340Separate eyelid adhesions4630
68360Revise eyelid lining2446
68362Revise eyelid lining2446
68500Removal of tear gland3510
68505Partial removal, tear gland3510
68510Biopsy of tear gland1333
68520Removal of tear sac3510
68525Biopsy of tear sac1333
68540Remove tear gland lesion3510
68550Remove tear gland lesion3510
68700Repair tear ducts2446
68720Create tear sac drain4630
68745Create tear duct drain4630
68750Create tear duct drain4630
68770AClose tear system fistula4630
68810Probe nasolacrimal duct1333
68811Probe nasolacrimal duct2446
68815Probe nasolacrimal duct2446
69110Remove external ear, partial1333
69120Removal of external ear2446
69140Remove ear canal lesion(s)2446
69145Remove ear canal lesion(s)2446
69150Extensive ear canal surgery3510
69205Clear outer ear canal1333
69300ARevise external ear3510
69310Rebuild outer ear canal3510
69320Rebuild outer ear canal7995
69421Incision of eardrum3510
69424DRemove ventilating tube1333
69436Create eardrum opening3510
69440Exploration of middle ear3510
69450Eardrum revision1333
69501Mastoidectomy7995
69502Mastoidectomy7995
69505Remove mastoid structures7995
69511Extensive mastoid surgery7995
69530Extensive mastoid surgery7995
69550Remove ear lesion5717
69552Remove ear lesion7995
69601Mastoid surgery revision7995
69602Mastoid surgery revision7995
69603Mastoid surgery revision7995
69604Mastoid surgery revision7995
69605Mastoid surgery revision7995
69620Repair of eardrum2446
69631Repair eardrum structures5717
69632Rebuild eardrum structures5717
69633Rebuild eardrum structures5717
69635Repair eardrum structures7995
69636Rebuild eardrum structures7995
69637Rebuild eardrum structures7995
69641Revise middle ear & mastoid7995
69642Revise middle ear & mastoid7995
69643Revise middle ear & mastoid7995
69644Revise middle ear & mastoid7995
69645Revise middle ear & mastoid7995
Start Printed Page 15312
69646Revise middle ear & mastoid7995
69650Release middle ear bone7995
69660Revise middle ear bone5717
69661Revise middle ear bone5717
69662Revise middle ear bone5717
69666Repair middle ear structures4630
69667Repair middle ear structures4630
69670Remove mastoid air cells3510
69676Remove middle ear nerve3510
69700Close mastoid fistula3510
69710DImplant/replace hearing aid3510
69711Remove/repair hearing aid1333
69714A*Implant temple bone w/stimul91339
69715A*Temple bne implnt w/stimulat91339
69717A*Temple bone implant revision91339
69718A*Revise temple bone implant91339
69720Release facial nerve5717
69725Release facial nerve5717
69740Repair facial nerve5717
69745Repair facial nerve5717
69801Incise inner ear5717
69802Incise inner ear7995
69805Explore inner ear7995
69806Explore inner ear7995
69820Establish inner ear window5717
69840Revise inner ear window5717
69905Remove inner ear7995
69910Remove inner ear & mastoid7995
69915Incise inner ear nerve7995
69930Implant cochlear device7995
G0105Colorectal scrn; hi risk ind2446
G0121Colon ca scrn; barium enema2446
G0260A*Inj for sacroiliac jt anesth1333
“A”=Addition.  “A*”=For Comment.  “D”=Deletion.
Note: CPT codes are copyright 2002 American Medical Association. All Rights Reserved.
End Supplemental Information

[FR Doc. 03-7236 Filed 3-27-03; 8:45 am]

BILLING CODE 4120-01-P