Many inpatient procedures may be safely and effectively performed in an ambulatory surgical center (ASC) or other outpatient setting without compromising the quality of patient care. These services are eligible for benefit coverage under HMSA plans only when performed in an ASC or lower-level setting such as a physician's office, unless the physician has contacted HMSA to precertify benefit coverage in a more acute setting (e.g., inpatient hospital).
This list does not supersede medical policy requirements.
| CPT Procedure Code | Outpatient Procedures – Description |
|---|---|
| 11406 | Excision, benign lesion, except skin tag (unless listed elsewhere), trunk, arms, or legs; excised diameter over 4.0 cm |
| 11446 | Excision, other benign lesion including margins (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm |
| 11450 | Excision of skin and subcutaneous tissue for hidradenitis, axillary; with simple or intermediate repair |
| 11462 | Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair |
| 11770 | Excision of pilonidal cyst or sinus; simple |
| 11971 | Removal of tissue expander(s) without insertion of prosthesis (See Cosmetic and Reconstructive Surgery and Services) |
| 14001 | Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm |
| 14021 | Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm |
| 14041 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm |
| 14060 | Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less |
| 15100 | Split graft, trunk, arms, legs; first 100 sq cm or less, or 1 percent of body area of infants and children |
| 15120 | Split graft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or less, or 1 percent of body area of infants and children |
| 15576 | Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral |
| 15600 | Delay of flap or sectioning of flap (division and inset); at trunk |
| 15620 | at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet |
| 15630 | at eyelids, nose, ears, or lips |
| 15823 | Blepharoplasty, upper eyelid; with excessive skin weighing down lid. (See Blepharoplasty and Repair of Blepharoptosis) |
| 15850 | Removal of sutures under anesthesia (other than local), same surgeon |
| 19101 | Biopsy of breast; open, incisional |
| 19110 | Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct |
| 19125 | Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion |
| 19290 | Preoperative placement of needle localization wire, breast |
| 19370 | Open periprosthetic capsulotomy, breast (See Cosmetic and Reconstructive Surgery and Services) |
| 20200 | Biopsy, muscle; superficial |
| 20205 | deep |
| 20220 | Biopsy, bone, trocar or needle; superficial (e.g., ilium, sternum, spinous process, ribs) |
| 20225 | deep (e.g., vertebral body, femur) |
| 20240 | Biopsy, bone, excisional; superficial (e.g., ilium, sternum, spinous process, ribs, trochanter of femur) |
| 20245 | deep (e.g., humerus, ischium, femur) |
| 20525 | Removal of foreign body in muscle or tendon sheath; deep or complicated |
| 20670 | Removal of implant; superficial (e.g. buried wire, pin or rod) (separate procedure) |
| 20680 | Removal of implant; deep (e.g., buried wire, pin, screw, metal band, nail, rod or plate) |
| 20693 | Adjustment or revision of external fixation system requiring anesthesia (e.g., new pin(s) or wire(s) and/or new ring(s) or bar(s)) |
| 20694 | Removal, under anesthesia, of external fixation system |
| 21320 | Closed treatment of nasal bone fracture; with stabilization |
| 21336 | Open treatment of nasal septal fracture, with or without stabilization |
| 21400 | Closed treatment of fracture of orbit, except blowout; without manipulation |
| 21453 | Closed treatment of mandibular fracture with interdental fixation |
| 21925 | Biopsy, soft tissue of back or flank; deep |
| 21930 | Excision, tumor, soft tissue of back or flank |
| 22900 | Excision, abdominal wall tumor, subfascial (e.g., desmoid) |
| 23350 | Injection procedure for shoulder arthrography or enhanced CT/MRI shoulder arthrography |
| 23655 | Closed treatment of shoulder dislocation, with manipulation; requiring anesthesia |
| 23700 | Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded) |
| 23930 | Incision and drainage, upper arm or elbow area; deep abscess or hematoma |
| 24075 | Excision, tumor, soft tissue of upper arm or elbow area; subcutaneous |
| 24105 | Excision, olecranon bursa |
| 24350 | Fasciotomy, lateral or medial (e.g., tennis elbow or epicondylitis) |
| 25000 | Incision, extensor tendon sheath, wrist (e.g., deQuervains disease) |
| 25076 | Excision, tumor, soft tissue of forearm and/or wrist area; deep (subfascial or intramuscular) |
| 25101 | Arthrotomy, wrist joint; with joint exploration, with or without biopsy, with or without removal of loose or foreign body |
| 25110 | Excision, lesion of tendon sheath, forearm and/or wrist |
| 25111 | Excision of ganglion, wrist (dorsal or volar); primary |
| 25112 | recurrent |
| 25116 | Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (e.g., tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); extensors, with or without transposition of dorsal retinaculum |
| 25118 | Synovectomy, extensor tendon sheath, wrist, single compartment |
| 25120 | Excision or curettage of bone cyst or benign tumor of radius or ulna (excluding head or neck of radius and olecranon process) |
| 25210 | Carpectomy; one bone |
| 25246 | Injection procedure for wrist arthrography |
| 25248 | Exploration with removal of deep foreign body, forearm or wrist |
| 25270 | Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle |
| 25295 | Tenolysis, flexor or extensor tendon, forearm and/or wrist, single; each tendon |
| 25310 | Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendon |
| 25535 | Closed treatment of ulnar shaft fracture; with manipulation |
| 25606 | Percutaneous skeletal fixation of distal radial fracture or epiphyseal separation |
| 25607 | Open treatment of distal radial extra-articular fracture or epiphyseal separation, with internal fixation |
| 25608 | Open treatment of distal radial intra-articular fracture or epiphyseal separation, with internal fixation of 2 fragments |
| 25609 | with internal fixation of 3 or more fragments |
| 26020 | Drainage of tendon sheath, digit and/or palm, each |
| 26040 | Fasciotomy, palmar (e.g., Dupuytren's contracture); percutaneous |
| 26045 | open, partial |
| 26055 | Tendon sheath incision (e.g., for trigger finger) |
| 26070 | Arthrotomy, with exploration, drainage, or removal of loose or foreign body; carpometacarpal joint |
| 26075 | metacarpophalangeal joint, each |
| 26080 | interphalangeal joint, each |
| 26100 | Arthrotomy with biopsy; carpometacarpal joint, each |
| 26105 | metacarpophalangeal joint, each |
| 26110 | interphalangeal joint, each |
| 26115 | Excision, tumor or vascular malformation, soft tissue of hand or finger; subcutaneous |
| 26116 | deep (subfascial, intramuscular) |
| 26121 | Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) |
| 26130 | Synovectomy, carpometacarpal joint |
| 26135 | Synovectomy, metacarpophalangeal joint including intrinsic release and extensor hood reconstruction, each digit |
| 26145 | Synovectomy tendon sheath, radical (tenosynovectomy), flexor tendon, palm and/or finger, each tendon |
| 26160 | Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger |
| 26210 | Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger |
| 26410 | Repair, extensor tendon, hand, primary or secondary; without free graft, each tendon |
| 26418 | Repair, extensor tendon, finger, primary or secondary; without free graft, each tendon |
| 26426 | Repair of extensor tendon, central slip, secondary (e.g., boutonniere deformity); using local tissue(s), including lateral band(s), each tendon |
| 26432 | Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (e.g., mallet finger) |
| 26433 | Repair of extensor tendon, distal insertion, primary or secondary; without graft (e.g., mallet finger) |
| 26440 | Tenolysis, flexor tendon; palm or finger, each tendon |
| 26442 | palm and finger, each tendon |
| 26445 | Tenolysis, extensor tendon, hand or finger, each tendon |
| 26449 | Tenolysis, complex, extensor tendon, finger, including forearm, each tendon |
| 26450 | Tenotomy, flexor, palm, open, each tendon |
| 26455 | Tenotomy, flexor, finger, open, each tendon |
| 26460 | Tenotomy, extensor, hand or finger, open, each tendon |
| 26540 | Repair of collateral ligament, metacarpophalangeal or interphalangeal joint |
| 26608 | Percutaneous skeletal fixation of metacarpal fracture, each bone |
| 26650 | Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation, with or without external fixation |
| 26676 | Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint |
| 26735 | Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with or without internal or external fixation, each |
| 26746 | Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, with or without internal or external fixation, each |
| 26765 | Open treatment of distal phalangeal fracture, finger or thumb, with or without internal or external fixation, each |
| 26785 | Open treatment of interphalangeal joint dislocation, with or without internal or external fixation, single |
| 26850 | Arthrodesis, metacarpophalangeal joint, with or without internal fixation |
| 27041 | Biopsy, soft tissue of pelvis and hip area; deep, subfascial or intramuscular |
| 27327 | Excision, tumor, thigh or knee area; subcutaneous |
| 27328 | deep, subfascial, or intramuscular |
| 27333 | Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial and lateral |
| 27340 | Excision, prepatellar bursa |
| 27350 | Patellectomy or hemipatellectomy |
| 27355 | Excision or curettage of bone cyst or benign tumor of femur |
| 27370 | Injection procedure for knee arthrography |
| 27372 | Removal of foreign body, deep, thigh region or knee area |
| 27570 | Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) |
| 27610 | Arthrotomy, ankle, including exploration, drainage, or removal of foreign body |
| 27612 | Arthrotomy, posterior capsular release, ankle, with or without Achilles tendon lengthening |
| 27614 | Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) |
| 27619 | Excision, tumor, leg or ankle area; deep (subfascial or intramuscular) |
| 27635 | Excision or curettage of bone cyst or benign tumor, tibia or fibula |
| 27762 | Closed treatment of medial malleolus fracture; with manipulation, with or without skin or skeletal traction |
| 28008 | Fasciotomy, foot and/or toe |
| 28035 | Release, tarsal tunnel (posterior tibial nerve decompression) |
| 28046 | Radical resection of tumor (e.g., malignant neoplasm), soft tissue of foot |
| 28080 | Excision, interdigital (Morton) neuroma, single, each |
| 28090 | Excision of lesion, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); foot |
| 28092 | toe(s), each |
| 28108 | Excision or curettage of bone cyst or benign tumor, phalanges of foot |
| 28110 | Ostectomy, partial excision, fifth metatarsal head (bunionette) (separate procedure) |
| 28111 | Ostectomy, complete excision; first metatarsal head |
| 28119 | Ostectomy, calcaneus; for spur, with or without plantar fascial release |
| 28122 | Partial excision (craterization, saucerization, sequestrectomy or diaphysectomy) bone (e.g., osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus |
| 28193 | Removal of foreign body, foot; complicated |
| 28200 | Repair, tendon, flexor, foot; primary or secondary, without free graft, each tendon |
| 28208 | Repair, tendon, extensor, foot; primary or secondary, each tendon |
| 28250 | Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure) |
| 28272 | Capsulotomy; interphalangeal joint, each joint (separate procedures) |
| 28285 | Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy) |
| 28288 | Ostectomy, partial, exostectomy or condylectomy, metatarsal head, each metatarsal head |
| 28289 | Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint |
| 28290 | Correction, hallux valgus (bunion), with or without sesamoidectomy; simple exostectomy (e.g., Silver type procedure) |
| 28292 | Keller, McBride or Mayo type procedure |
| 28293 | resection of joint with implant |
| 28296 | with metatarsal osteotomy (e.g., Mitchell, Chevron, or concentric type procedures) |
| 28297 | Lapidus type procedure |
| 28315 | Sesamoidectomy, first toe (separate procedure) |
| 28341 | Reconstruction, toe, macrodactyly; requiring bone resection |
| 28476 | Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each |
| 28505 | Open treatment of fracture great toe, phalanx or phalanges, with or without internal or external fixation |
| 29805 | Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure) |
| 29819 | Arthroscopy, shoulder, surgical; capsulorrhaphy; with removal of loose body or foreign body |
| 29822 | debridement, limited |
| 29823 | debridement, extensive |
| 29825 | with lysis and resection of adhesions, with or without manipulation |
| 29826 | decompression of subacromial space with partial acromioplasty, with or without coracoacromial release |
| 29830 | Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure) |
| 29834 | Arthroscopy, elbow, surgical; with removal of loose body or foreign body |
| 29837 | debridement, limited |
| 29838 | debridement, extensive |
| 29848 | Endoscopy, wrist, surgical, with release of transverse carpal ligament |
| 29870 | Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure) |
| 29871 | Arthroscopy, knee, surgical; for infection, lavage and drainage |
| 29874 | for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation) |
| 29877 | debridement/shaving of articular cartilage (chondroplasty) |
| 29881 | with meniscectomy (medical or lateral, including any meniscal shaving) |
| 29884 | with lysis of adhesions, with or without manipulation (separate procedure) |
| 29894 | Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body |
| 29895 | synovectomy, partial |
| 29897 | debridement, limited |
| 29898 | debridement, extensive |
| 29999 | Unlisted procedure, arthroscopy |
| 30130 | Excision inferior turbinate, partial or complete, any method |
| 30140 | Submucous resection inferior turbinate, partial or complete, any method |
| 30520 | Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft |
| 30930 | Fracture nasal inferior turbinate(s), therapeutic |
| 31020 | Sinusotomy, maxillary (antrotomy); intranasal |
| 31051 | Sinusotomy, sphenoid, with or without biopsy; with mucosal stripping or removal of polyp(s) |
| 31090 | Sinusotomy, unilateral, three or more paranasal sinuses (frontal, maxillary, ethmoid, sphenoid) |
| 31239 | Nasal/sinus endoscopy, surgical; with dacryocystorhinostomy |
| 31256 | Nasal/sinus endoscopy, surgical; with maxillary antrostomy |
| 31530 | Laryngoscopy, direct, operative, with foreign body removal |
| 31577 | Laryngoscopy, flexible fiberoptic; with removal of foreign body |
| 31622 | Bronchoscopy, rigid or flexible; with or without fluoroscopic guidance; diagnostic, with or without cell washing (separate procedure) |
| 31623 | with brushing or protected brushings |
| 31625 | with bronchial or endobronchial biopsy(s), single or multiple sites |
| 31629 | with transbronchial needle aspiration biopsy(s), trachea, main stem and/or lobar bronchus(i) |
| 31635 | with removal of foreign body |
| 31641 | Bronchoscopy, (rigid or flexible); with destruction of tumor or relief of stenosis by any method other than excision (e.g., laser therapy, cryotherapy) |
| 32405 | Biopsy, lung or mediastinum, percutaneous needle |
| 32664 | Thoracoscopy, surgical; with thoracic sympathectomy |
| 36005 | Injection procedure for extremity venography (including introduction of needle or intracatheter) |
| 36012 | Selective catheter placement, venous system; second order, or more selective, branch (e.g., left adrenal vein, petrosal sinus) |
| 36246 | Selective catheter placement, arterial system; initial second order abdominal, pelvic or lower extremity artery branch, within a vascular family |
| 37609 | Ligation or biopsy, temporal artery |
| 37785 | Ligation, division, and/or excision of varicose veins cluster(s), one leg |
| 38500 | Biopsy or excision of lymph node(s); open, superficial |
| 38510 | open, deep cervical node(s) |
| 38550 | Excision of cystic hygroma, axillary or cervical; without deep neurovascular dissection |
| 40525 | Excision of lip; full thickness, reconstruction with local flap (e.g., Estlander or fan) |
| 40720 | Plastic repair of cleft lip/nasal deformity; secondary, by recreation of defect and reclosure |
| 40810 | Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair |
| 40819 | Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy) |
| 41010 | Incision of lingual frenum (frenotomy) |
| 41115 | Excision of lingual frenum (frenectomy) |
| 41850 | Destruction of lesion (except excision), dentoalveolar structures |
| 42409 | Marsupialization of sublingual salivary cyst (ranula) |
| 42700 | Incision and drainage abscess; peritonsillar |
| 42802 | Biopsy; hypopharynx |
| 42815 | Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx |
| 42830 | Adenoidectomy, primary; younger than 12 |
| 42860 | Excision of tonsil tags |
| 43200 | Esophagoscopy, rigid or flexible; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) |
| 43202 | with biopsy, single or multiple |
| 43215 | with removal of foreign body |
| 43220 | with balloon dilation (less than 30 mm diameter) |
| 43226 | with insertion of guide wire followed by dilation over guide wire |
| 43234 | Upper gastrointestinal endoscopy, simple primary examination (e.g., with small diameter flexible endoscope) (separate procedure) |
| 43235 | Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) |
| 43239 | with biopsy, single or multiple |
| 43244 | with band ligation of esophageal and/or gastric varices |
| 43245 | with dilation of gastric outlet for obstruction (e.g., balloon, guide wire, bougie) |
| 43246 | with directed placement of percutaneous gastrostomy tube |
| 43247 | with removal of foreign body |
| 43248 | with insertion of guide wire followed by dilation of esophagus over guide wire |
| 43249 | with balloon dilation of esophagus (less than 30 mm diameter) |
| 43250 | with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery |
| 43251 | with removal of tumor(s), polyp(s), or other lesion(s) by snare technique |
| 43258 | with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
| 43260 | Endoscopic retrograde cholangiopancreatography (ERCP); diagnostic, with or without collection of specimen(s) by brushing or washing |
| 43261 | with biopsy, single or multiple |
| 43450 | Dilation of esophagus, by unguided sound or bougie, single or multiple passes |
| 43453 | Dilation of esophagus, over guide wire |
| 43456 | Dilation of esophagus, by balloon or dilator; retrograde |
| 43770 | Laparoscopy, surgical, gastric restrictive procedure; placement of adjustable gastric restrictive device |
| 43771 | Laparoscopy, surgical, gastric restrictive procedure; revision of adjustable gastric restrictive device |
| 43773 | Removal and replacement of adjustable gastric restrictive device |
| 44377 | Small intestinal endoscopy, enteroscopy beyond second portion of duodenum, including ileum; with biopsy, single or multiple |
| 44380 | Ileoscopy, through stoma; diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) |
| 44382 | with biopsy, single or multiple |
| 44389 | Colonoscopy through stoma; with biopsy, single or multiple |
| 44392 | Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery |
| 45100 | Biopsy of anorectal wall, anal approach (e.g., congenital megacolon) |
| 45170 | Excision of rectal tumor, transanal approach |
| 45308 | Protosigmoidoscopy, rigid; with removal of single tumor, polyp, or other lesion by hot biopsy forceps or bipolar cautery |
| 45309 | with removal of single tumor, polyp, or other lesion by snare technique |
| 45315 | with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique |
| 45333 | Sigmoidoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery |
| 45339 | with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery, or snare technique |
| 45378 | Colonoscopy, flexible, proximal to splenic flexure; diagnostic, with or without collection of specimen(s) by brushing or washing, with or without colon decompression (separate procedure) |
| 45379 | with removal of foreign body |
| 45380 | with biopsy, single or multiple |
| 45383 | with ablation of tumor(s), polyp(s), or other lesion(s) not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique |
| 45384 | with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps or bipolar cautery |
| 45385 | with removal of tumor(s), polyp(s), or other lesion(s) by snare technique |
| 45505 | Proctoplasty; for prolapse of mucous membrane |
| 45905 | Dilation of anal sphincter (separate procedure) under anesthesia other than local |
| 45990 | Anorectal exam, surgical, requiring anesthesia (general, spinal or epidural), diagnostic |
| 46045 | Incision and drainage of intramural, intramuscular or submucosal abscess, transanal, under anesthesia |
| 46060 | Incision and drainage of ischiorectal or intramural abscess, with fistulectomy or fistulotomy, submuscular, with or without placement of seton |
| 46080 | Sphincterotomy, anal, division of sphincter |
| 46200 | Fissurectomy, with or without sphincterotomy |
| 46612 | Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique |
| 46700 | Anoplasty, plastic operation for stricture; adult |
| 46924 | Destruction of lesion(s), anus (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) |
| 47000 | Biopsy of liver, needle; percutaneous |
| 47505 | Injection procedure for cholangiography through an existing catheter (e.g., percutaneous transhepatic or T-tube) |
| 48102 | Biopsy of pancreas, percutaneous needle |
| 49080 | Peritoneocentesis, abdominal paracentesis, or peritoneal lavage (diagnostic or therapeutic); initial |
| 49081 | subsequent |
| 49180 | Biopsy, abdominal or retroperitoneal mass, percutaneous needle |
| 49250 | Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) |
| 50200 | Renal biopsy; percutaneous, by trocar or needle |
| 50394 | Injection procedure for pyelography (as nephrostogram, pyelostogram, antegrade pyeloureterograms) through nephrostomy or pyelostomy tube, or indwelling ureteral catheter |
| 50398 | Change of nephrostomy or pyelostomy tube |
| 51600 | Injection procedure for cystography or voiding urethrocystography |
| 51726 | Complex cystometrogram (e.g., calibrated electronic equipment) |
| 51741 | Complex uroflowmetry (UFR) (e.g., stop-watch flow rate, mechanical uroflowmeter) |
| 51772 | Urethral pressure profile studies (UPP) (urethral closure pressure profile), any technique |
| 51784 | Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique |
| 51785 | Needle electromyography studies (EMG) of anal or urethral sphincter, any technique |
| 52005 | Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service |
| 52204 | Cystourethroscopy, with biopsy |
| 52214 | Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands |
| 52224 | Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy |
| 52234 | Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 to 2.0 cm) |
| 52235 | MEDIUM bladder tumor(s) (2.0 to 5.0 cm) |
| 52240 | LARGE bladder tumor(s) |
| 52250 | Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration |
| 52260 | Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia |
| 52270 | Cystourethroscopy, with internal urethrotomy; female |
| 52275 | male |
| 52276 | Cystourethroscopy with direct vision internal urethrotomy |
| 52285 | Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone |
| 52290 | Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral |
| 52300 | with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral |
| 52315 | Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated |
| 53450 | Urethromeatoplasty, with mucosal advancement |
| 54001 | Slitting of prepuce, dorsal or lateral (separate procedure); except newborn |
| 54152 | Circumcision, using clamp or other device; except newborn |
| 54161 | Circumcision, surgical excision other than clamp, device or dorsal slit; except newborn |
| 54360 | Plastic operation on penis to correct angulation |
| 54450 | Foreskin manipulation including lysis of preputial adhesions and stretching |
| 54700 | Incision and drainage of epididymis, testis and/or scrotal space (e.g., abscess or hematoma) |
| 54840 | Excision of spermatocele, with or without epididymectomy |
| 55060 | Repair of tunica vaginalis hydrocele (Bottle type) |
| 55500 | Excision of hydrocele of spermatic cord, unilateral (separate procedure) |
| 55535 | Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach |
| 55700 | Biopsy, prostate; needle or punch, single or multiple, any approach |
| 56440 | Marsupialization of Bartholin’s gland cyst |
| 56441 | Lysis of labial adhesions |
| 56620 | Vulvectomy simple; partial |
| 56740 | Excision of Bartholin’s gland or cyst |
| 57000 | Colpotomy; with exploration |
| 57105 | Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) |
| 57200 | Colporrhaphy, suture of injury of vagina (nonobstetrical) |
| 57410 | Pelvic examination under anesthesia |
| 57513 | Cautery of cervix; laser ablation |
| 57520 | Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser |
| 57522 | loop electrode excision |
| 57700 | Cerclage of uterine cervix, nonobstetrical |
| 58120 | Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical) |
| 58340 | Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography |
| 58345 | Transcervical introduction of fallopian tube catheter for diagnosis and/or reestablishing patency (any method), with or without hysterosalpingography |
| 58545 | Laparoscopy, surgical, myomectomy, excision;1 to 4 intramural myomas with total weight of 250g or less and/or removal of surface myomas |
| 58555 | Hysteroscopy, diagnostic |
| 58558 | Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C |
| 58559 | with lysis of intrauterine adhesions |
| 58560 | with division or resetion of intrauterine septum |
| 58561 | with removal of leiomyomata |
| 58562 | with removal of impacted foreign body |
| 58563 | with endometrial ablation |
| 58565 | with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants |
| 58660 | Laparoscopy, surgical; with lysis of adhesions |
| 58661 | with removal of adnexal structures |
| 58662 | with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface |
| 58670 | with fulguration of oviducts |
| 58671 | with occlusion of oviducts by device |
| 58673 | with salpingostomy (salpingoneostomy) |
| 59840 | Induced abortion, by dilation and curettage |
| 59841 | Induced abortion, by dilation and evacuation |
| 60200 | Excision of cyst or adenoma of thyroid, or transection of isthmus |
| 60210 | Partial thyroid lobectomy, unilateral; with or without isthmusectomy |
| 60220 | Total thyroid lobectomy, unilateral; with or without isthmusectomy |
| 60225 | with contralateral subtotal lobectomy, including isthmusectomy |
| 62270 | Spinal puncture, lumbar, diagnostic |
| 62272 | Spinal puncture, therapeutic, for drainage of cerebrospinal fluid (by needle or catheter) |
| 62273 | Injection, epidural, of blood or clot patch |
| 62281 | Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions); with or without other therapeutic substance; epidural, cervical or thoracic |
| 62282 | epidural, lumbar, sacral (caudal) |
| 62284 | Injection procedure for myelography and/or computed tomography, spinal (other than C1-C2 and posterior fossa) |
| 62290 | Injection procedure for diskography, each level; lumbar |
| 62291 | cervical or thoracic |
| 62311 | Injection, single (not via indwelling catheter), not including neurolytic substances, with or without contrast (for either localization or epidurography), of diagnostic or therapeutic substance(s) (including anesthetic, antispasmodic, opioid, steroid, other solution), epidural or subarachnoid; lumbar, sacral (caudal) |
| 64402 | Injection, anesthetic agent; facial nerve |
| 64476 | Injection, anesthetic agent and/or steroid, paravertebral facet joint or facet joint nerve; lumbar or sacral, each additional level |
| 64479 | Injection, anesthetic agent and/or steroid, transforaminal epidural; cervical or thoracic, single level |
| 64483 | lumbar or sacral, single level |
| 64510 | Injection, anesthetic agent; stellate ganglion (cervical sympathetic) |
| 64530 | celiac plexus, with or without radiologic monitoring |
| 64680 | Destruction by neurolytic agent, with or without radiologic monitoring; celiac plexus |
| 64719 | Neuroplasty and/or transposition; ulnar nerve at wrist |
| 64721 | median nerve at carpal tunnel |
| 65103 | Enucleation of eye; with implant, muscles not attached to implant |
| 65125 | Modification of ocular implant with placement or replacement of pegs (e.g., drilling receptacle for prosthesis appendage) (separate procedure) |
| 65140 | Insertion of ocular implant secondary; after enucleation, muscles attached to implant |
| 65290 | Repair of wound, extraocular muscle, tendon and/or Tenon's capsule |
| 65426 | Excision or transposition of pterygium; with graft |
| 65450 | Destruction of lesion of cornea by cryotherapy, photocoagulation or thermocauterization |
| 65600 | Multiple punctures of anterior cornea (e.g., for corneal erosion, tattoo) |
| 65820 | Goniotomy |
| 65855 | Trabeculoplasty by laser surgery, one or more sessions (defined treatment series) |
| 66170 | Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery |
| 66180 | Aqueous shunt to extraocular reservoir, (e.g., Molteno, Schocket, Denver-Krupin) |
| 66250 | Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure |
| 66720 | Ciliary body destruction; cryotherapy |
| 66761 | Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (one or more sessions) |
| 66762 | Iridoplasty by photocoagulation (one or more sessions) (e.g., for improvement of vision, for widening of anterior chamber angle) |
| 66821 | Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., Yag laser) (one or more stages) |
| 66825 | Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) |
| 66830 | Removal of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid) with corneo-scleral section, with or without iridectomy (iridocapsulotomy, iridocapsulectomy) |
| 66840 | Removal of lens material; aspiration technique, one or more stages |
| 66850 | phacofragmentation technique (mechanical or ultrasonic) (e.g., phacoemulsification), with aspiration |
| 66852 | pars plana approach, with or without vitrectomy |
| 66920 | intracapsular |
| 66930 | intracapsular, for dislocated lens |
| 66940 | extracapsular (other than 66840, 66850, 66852) |
| 66982 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (e.g., iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage |
| 66983 | Intracapsular cataract extraction with insertion of intraocular lens prosthesis (one stage procedure) |
| 66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis (one stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification) |
| 66985 | Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal |
| 67031 | Severing of vitreous strands, vitreous face adhesions, sheets, membranes or opacities, laser surgery (one or more stages) |
| 67101 | Repair of retinal detachment, one or more sessions; cryotherapy or diathermy, with or without drainage of subretinal fluid |
| 67105 | photocoagulation, with or without drainage of subretinal fluid |
| 67121 | Removal of implanted material, posterior segment; intraocular |
| 67141 | Prophylaxis of retinal detachment (e.g., retinal break, lattice degeneration) without drainage, one or more sessions; cryotherapy, diathermy |
| 67145 | photocoagulation (laser or xenon arc) |
| 67208 | Destruction of localized lesion of retina (e.g., macular edema, tumors) one or more sessions; cryotherapy, diathermy |
| 67210 | photocoagulation |
| 67227 | Destruction of extensive or progressive retinopathy (e.g., diabetic retinopathy), one or more sessions; cryotherapy, diathermy |
| 67228 | photocoagulation (laser or xenon arc) |
| 67311 | Strabismus surgery, recession or resection procedure; one horizontal muscle |
| 67312 | two horizontal muscles |
| 67331 | Strabismus surgery on patient with previous eye surgery or injury that did not involve the extraocular muscles (List separately in addition to code for primary procedure) |
| 67332 | Strabismus surgery on patient with scarring of extraocular muscles (e.g., prior ocular injury, strabismus or retinal detachment surgery) or restrictive myopathy (e.g., dysthyroid ophthalmopathy) (List separately in addition to code for primary procedure) |
| 67334 | Strabismus surgery by posterior fixation suture technique, with or without muscle recession |
| 67400 | Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy |
| 67901 | Repair of blepharoptosis; frontalis muscle technique with suture or other material (When submitting claims, submit an operative report or other documentation.) (See Complex Wound Repairs and Complicated Incisions) |
| 67902 | frontalis muscle technique with fascial sling (includes obtaining fascia) (When submitting claims, submit an operative report or other documentation.) (See Complex Wound Repairs and Complicated Incisions) |
| 67903 | (tarso) levator resection or advancement, internal approach (When submitting claims, submit an operative report or other documentation.) (See Complex Wound Repairs and Complicated Incisions) |
| 67904 | (tarso) levator resection or advancement, external approach (When submitting claims, submit an operative report or other documentation.) (See Cosmetic and Reconstructive Surgery and Services) |
| 67906 | superior rectus technique with fascial sling (includes obtaining fascia) |
| 67908 | conjunctivo-tarso-Muller's muscle-levator resection (e.g., Fasanella-Servat type) |
| 67914 | Repair of ectropion; suture |
| 67915 | thermocauterization |
| 67916 | excision tarsal wedge |
| 67917 | extensive (e.g., tarsal strip operations) |
| 67921 | Repair of entropion; suture |
| 67922 | thermocauterization |
| 67923 | excision tarsal wedge |
| 67924 | Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation). (When submitting claims, submit an operative report or other documentation.) (See Cosmetic and Reconstructive Surgery and Services) |
| 67950 | Canthoplasty (reconstruction of canthus) |
| 67973 | Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, one stage or first stage |
| 68115 | Excision of lesion, conjunctiva; over 1 cm |
| 68135 | Destruction of lesion, conjunctiva |
| 68320 | Conjunctivoplasty; with conjunctival graft or extensive rearrangement |
| 68326 | Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement |
| 68700 | Plastic repair of canaliculi |
| 68811 | Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia |
| 68815 | with insertion of tube or stent |
| 69205 | Removal foreign body from external auditory canal; with general anesthesia |
| 69421 | Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia |
| 69424 | Ventilating tube removal requiring general anesthesia |
| 69440 | Middle ear exploration through postauricular or ear canal incision |
| 69540 | Excision aural polyp |
| 69643 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction |
| 69660 | Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material |
Revision History
| Date | Nature of Revision |
|---|---|
| 08/03/2026 | Migrated to new platform.
|