Crystal's MCW Coder HubUnitedHealthcare® Commercial Policy Appendix: Applicable Code List Outpatient Surgical Procedures - Site of Service: CPT/HCPCS Codes This list of codes applies to the Medical Policy titled Outpatient Surgical Effective Date: January 1, 2026 Procedures - Site of Service for Commercial plans. Applicable Codes The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. The listing of a code does not imply that the service described by the code is a covered or non-covered health service. Benefit coverage for health services is determined by the member specific benefit plan document and applicable laws that may require coverage for a specific service. The inclusion of a code does not imply any right to reimbursement or guarantee claim payment. Other Policies and Guidelines may apply. This list contains CPT/HCPCS codes for the following:
- Auditory System Female Genital System Musculoskeletal System
- Cardiovascular System Hemic and Lymphatic Systems Nervous System
- Digestive System Integumentary System Respiratory System
- Eye/Ocular Adnexa System Male Genital System Urinary System
CPT Code Description Auditory System
| Code | Description |
|---|---|
| 69100 | Biopsy external ear |
| 69110 | Excision external ear; partial, simple repair |
| 69140 | Excision exostosis(es), external auditory canal |
| 69145 | Excision soft tissue lesion, external auditory canal |
| 69205 | Removal foreign body from external auditory canal; with general anesthesia |
| 69222 | Debridement, mastoidectomy cavity, complex (e.g., with anesthesia or more than routine cleaning) |
| 69310 | Reconstruction of external auditory canal (meatoplasty) (e.g., for stenosis due to injury, infection) (separate procedure) |
| 69320 | Reconstruction external auditory canal for congenital atresia, single stage |
| 69421 | Myringotomy including aspiration and/or eustachian tube inflation requiring general anesthesia |
| 69424 | Ventilating tube removal requiring general anesthesia |
| 69433 | Tympanostomy (requiring insertion of ventilating tube), local or topical anesthesia |
| 69436 | Tympanostomy (requiring insertion of ventilating tube), general anesthesia |
| 69440 | Middle ear exploration through postauricular or ear canal incision |
| 69450 | Tympanolysis, transcanal |
| 69505 | Mastoidectomy; modified radical |
| 69550 | Excision aural glomus tumor; transcanal |
| 69602 | Revision mastoidectomy; resulting in modified radical mastoidectomy |
| 69610 | Tympanic membrane repair, with or without site preparation of perforation for closure, with or without patch |
| 69620 | Myringoplasty (surgery confined to drumhead and donor area) |
CPT Code Description Auditory System
| Code | Description |
|---|---|
| 69631 | Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; without ossicular chain reconstruction |
| 69632 | Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction (e.g., postfenestration) |
| 69633 | Tympanoplasty without mastoidectomy (including canalplasty, atticotomy and/or middle ear surgery), initial or revision; with ossicular chain reconstruction and synthetic prosthesis (e.g., partial ossicular replacement prosthesis [PORP], total ossicular replacement prosthesis [TORP]) |
| 69635 | Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); without ossicular chain reconstruction |
| 69636 | Tympanoplasty with antrotomy or mastoidotomy (including canalplasty, atticotomy, middle ear surgery, and/or tympanic membrane repair); with ossicular chain reconstruction |
| 69641 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); without ossicular chain reconstruction |
| 69642 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with ossicular chain reconstruction |
| 69643 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed wall, without ossicular chain reconstruction |
| 69644 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); with intact or reconstructed canal wall, with ossicular chain reconstruction |
| 69645 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, without ossicular chain reconstruction |
| 69646 | Tympanoplasty with mastoidectomy (including canalplasty, middle ear surgery, tympanic membrane repair); radical or complete, with ossicular chain reconstruction |
| 69650 | Stapes mobilization |
| 69660 | Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material |
| 69661 | Stapedectomy or stapedotomy with reestablishment of ossicular continuity, with or without use of foreign material; with footplate drill out |
| 69662 | Revision of stapedectomy or stapedotomy |
| 69801 | Labyrinthotomy, with perfusion of vestibuloactive drug(s), transcanal |
| 69805 | Endolymphatic sac operation; without shunt |
| 69806 | Endolymphatic sac operation; with shunt |
Cardiovascular System
| Code | Description |
|---|---|
| 33215 | Repositioning of previously implanted transvenous pacemaker or implantable defibrillator (right atrial or right ventricular) electrode |
| 33216 | Insertion of a single transvenous electrode, permanent pacemaker or implantable defibrillator |
| 33241 | Removal of implantable defibrillator pulse generator only |
| 36000 | Introduction of needle or intracatheter, vein |
| 36010 | Introduction of catheter, superior or inferior vena cava |
| 36012 | Selective catheter placement, venous system; second order, or more selective, branch (e.g., left adrenal vein, petrosal sinus) |
| 36215 | Selective catheter placement, arterial system; each first order thoracic or brachiocephalic branch, within a vascular family |
| 36246 | Selective catheter placement, arterial system; initial second order abdominal, pelvic, or lower extremity artery branch, within a vascular family |
| 36556 | Insertion of non-tunneled centrally inserted central venous catheter; age 5 years or older |
| 36569 | Insertion of peripherally inserted central venous catheter (PICC), without subcutaneous port or pump, without imaging guidance; age 5 years or older |
36571
Insertion of peripherally inserted central venous access device, with subcutaneous port; age 5 years or older
36581
Replacement, complete, of a tunneled centrally inserted central venous catheter, without subcutaneous port or pump, through same venous access
36582
Replacement, complete, of a tunneled centrally inserted central venous access device, with subcutaneous port, through same venous access
36589
Removal of tunneled central venous catheter, without subcutaneous port or pump
36590
Removal of tunneled central venous access device, with subcutaneous port or pump, central or peripheral insertion
36821
Arteriovenous anastomosis, open; direct, any site (e.g., Cimino type) (separate procedure)
36901
Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis
36902
Introduction of needle(s) and/or catheter(s), dialysis circuit, with diagnostic angiography of the dialysis circuit, including all direct puncture(s) and catheter placement(s), injection(s) of contrast, all necessary imaging from the arterial anastomosis
37242
Vascular embolization or occlusion, inclusive of all radiological supervision and interpretation, intraprocedural roadmapping, and imaging guidance necessary to complete the intervention; arterial, other than hemorrhage or tumor (e.g., congenital or acquire arterial malformations, arteriovenous malformations, arteriovenous fistulas, aneurysms, pseudoaneurysms)
37248
Transluminal balloon angioplasty (except dialysis circuit), open or percutaneous, including all imaging and radiological supervision and interpretation necessary to perform the angioplasty within the same vein; initial vein
37607
Ligation or banding of angioaccess arteriovenous fistula
37609
Ligation or biopsy, temporal artery
37761
Ligation of perforator vein(s), subfascial, open, including ultrasound guidance, when performed, 1 leg
37765
Stab phlebectomy of varicose veins, 1 extremity; 10-20 stab incisions
37766
Stab phlebectomy of varicose veins, 1 extremity; more than 20 incisions
37785
Ligation, division, and/or excision of varicose vein cluster(s), 1 leg
Digestive System
40810
Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair
40812
Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair
41110
Excision of lesion of tongue without closure
41112
Excision of lesion of tongue with closure; anterior two-thirds
41113
Excision of lesion of tongue with closure; posterior one-third
41520
Frenoplasty (surgical revision of frenum, e.g., with Z-plasty)
42104
Excision, lesion of palate, uvula; without closure
42106
Excision, lesion of palate, uvula; with simple primary closure
42140
Uvulectomy, excision of uvula
42145
Palatopharyngoplasty (e.g., uvulopalatopharyngoplasty, uvulopharyngoplasty)
42408
Excision of sublingual salivary cyst (ranula)
42420
Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve
42425
Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve
42440
Excision of submandibular (submaxillary) gland
42800
Biopsy; oropharynx
42810
Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues
CPT Code Description Digestive System 42821 Tonsillectomy and adenoidectomy; age 12 or over 42826 Tonsillectomy, primary or secondary; age 12 or over 42831 Adenoidectomy, primary; age 12 or over 43200 Esophagoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) 43202 Esophagoscopy, flexible, transoral; with biopsy, single or multiple 43220 Esophagoscopy, flexible, transoral; with transendoscopic balloon dilation (less than 30 mm diameter) 43226 Esophagoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) over guide wire 43229 Esophagoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) 43235 Esophagogastroduodenoscopy, flexible, transoral; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) 43236 Esophagogastroduodenoscopy, flexible, transoral; with directed submucosal injection(s), any substance 43239 Esophagogastroduodenoscopy, flexible, transoral; with biopsy, single or multiple 43247 Esophagogastroduodenoscopy, flexible, transoral; with removal of foreign body(s) 43248 Esophagogastroduodenoscopy, flexible, transoral; with insertion of guide wire followed by passage of dilator(s) through esophagus over guide wire 43249 Esophagogastroduodenoscopy, flexible, transoral; with transendoscopic balloon dilation of esophagus (less than 30 mm diameter) 43250 Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps 43251 Esophagogastroduodenoscopy, flexible, transoral; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 43254 Esophagogastroduodenoscopy, flexible, transoral; with endoscopic mucosal resection 43255 Esophagogastroduodenoscopy, flexible, transoral; with control of bleeding, any method 43270 Esophagogastroduodenoscopy, flexible, transoral; with ablation of tumor(s), polyp(s), or other lesion(s) (includes pre- and post-dilation and guide wire passage, when performed) 44388 Colonoscopy through stoma; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) 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 44394 Colonoscopy through stoma; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45172 Excision of rectal tumor, transanal approach; including muscularis propria (i.e., full thickness) 45378 Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure) 45379 Colonoscopy, flexible; with removal of foreign body(s) 45380 Colonoscopy, flexible; with biopsy, single or multiple 45381 Colonoscopy, flexible; with directed submucosal injection(s), any substance 45384 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by hot biopsy forceps 45385 Colonoscopy, flexible; with removal of tumor(s), polyp(s), or other lesion(s) by snare technique 45386 Colonoscopy, flexible; with transendoscopic balloon dilation 45390 Colonoscopy, flexible; with endoscopic mucosal resection 45398 Colonoscopy, flexible; with band ligation(s) (e.g., hemorrhoids)
CPT Code Description Digestive System 45990 Anorectal exam, surgical, requiring anesthesia (general, spinal, or epidural), diagnostic 46080 Sphincterotomy, anal, division of sphincter (separate procedure) 46200 Fissurectomy, including sphincterotomy, when performed 46220 Excision of single external papilla or tag, anus 46221 Hemorrhoidectomy, internal, by rubber band ligation(s) 46250 Hemorrhoidectomy, external, 2 or more columns/groups 46255 Hemorrhoidectomy, internal and external, single column/group 46257 Hemorrhoidectomy, internal and external, single column/group; with fissurectomy 46261 Hemorrhoidectomy, internal and external, 2 or more columns/groups; with fissurectomy 46270 Surgical treatment of anal fistula (fistulectomy/fistulotomy); subcutaneous 46505 Chemodenervation of internal anal sphincter 46612 Anoscopy; with removal of multiple tumors, polyps, or other lesions by hot biopsy forceps, bipolar cautery or snare technique 46910 Destruction of lesion(s), anus (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation 46946 Hemorrhoidectomy, internal, by ligation other than rubber band; 2 or more hemorrhoid columns/groups 47000 Biopsy of liver, needle; percutaneous 49505 Repair initial inguinal hernia, age 5 years or older; reducible 49550 Repair initial femoral hernia, any age; reducible 49650 Laparoscopy, surgical; repair initial inguinal hernia 49651 Laparoscopy, surgical; repair recurrent inguinal hernia Eye/Ocular Adnexa System 65400 Excision of lesion, cornea (keratectomy, lamellar, partial), except pterygium 65420 Excision or transposition of pterygium; without graft 65426 Excision or transposition of pterygium; with graft 65435 Removal of corneal epithelium; with or without chemocauterization (abrasion, curettage) 65436 Removal of corneal epithelium; with application of chelating agent (e.g., EDTA) 65710 Keratoplasty (corneal transplant); anterior lamellar 65730 Keratoplasty (corneal transplant); penetrating (except in aphakia or pseudophakia) 65750 Keratoplasty (corneal transplant); penetrating (in aphakia) 65755 Keratoplasty (corneal transplant); penetrating (in pseudophakia) 65756 Keratoplasty (corneal transplant); endothelial 65772 Corneal relaxing incision for correction of surgically induced astigmatism 65778 Placement of amniotic membrane on the ocular surface; without sutures 65779 Placement of amniotic membrane on the ocular surface; single layer, sutured 65780 Ocular surface reconstruction; amniotic membrane transplantation, multiple layers 65800 Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous 65815 Paracentesis of anterior chamber of eye (separate procedure); with removal of blood, with or without irrigation and/or air injection 65850 Trabeculotomy ab externo 65855 Trabeculoplasty by laser surgery 65865 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); goniosynechiae
CPT Code Description Eye/Ocular Adnexa System 65875 Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae 65920 Removal of implanted material, anterior segment of eye 66170 Fistulization of sclera for glaucoma; trabeculectomy ab externo in absence of previous surgery 66172 Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents) 66185 Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft 66250 Revision or repair of operative wound of anterior segment, any type, early or late, major or minor procedure 66682 Suture of iris, ciliary body (separate procedure) with retrieval of suture through small incision (e.g., McCannel suture) 66710 Ciliary body destruction; cyclophotocoagulation, transscleral 66711 Ciliary body destruction; cyclophotocoagulation, endoscopic 66761 Iridotomy/iridectomy by laser surgery (e.g., for glaucoma) (per session) 66821 Discission of secondary membranous cataract (opacified posterior lens capsule and/or anterior hyaloid); laser surgery (e.g., YAG laser) (1 or more stages) 66825 Repositioning of intraocular lens prosthesis, requiring an incision (separate procedure) 66840 Removal of lens material; aspiration technique, 1 or more stages 66850 Removal of lens material; phacofragmentation technique (mechanical or ultrasonic) (e.g., phacoemulsification), with aspiration 66852 Removal of lens material; pars plana approach, with or without vitrectomy 66982 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-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; without endoscopic cyclophotocoagulation 66983 Intracapsular cataract extraction with insertion of intraocular lens prosthesis (1 stage procedure) 66984 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); without endoscopic cyclophotocoagulation 66985 Insertion of intraocular lens prosthesis (secondary implant), not associated with concurrent cataract removal 66986 Exchange of intraocular lens 66987 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-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; with endoscopic cyclophotocoagulation 66988 Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (e.g., irrigation and aspiration or phacoemulsification); with endoscopic cyclophotocoagulation 67005 Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal 67010 Removal of vitreous, anterior approach (open sky technique or limbal incision); subtotal removal with mechanical vitrectomy 67025 Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure) 67028 Intravitreal injection of a pharmacologic agent (separate procedure) 67036 Vitrectomy, mechanical, pars plana approach 67039 Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation
CPT Code Description Eye/Ocular Adnexa System 67040 Vitrectomy, mechanical, pars plana approach; with endolaser panretinal photocoagulation 67041 Vitrectomy, mechanical, pars plana approach; with removal of preretinal cellular membrane (e.g., macular pucker) 67042 Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (e.g., for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (i.e., air, gas or silicone oil) 67043 Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (e.g., choroidal neovascularization), includes, if performed, intraocular tamponade (i.e., air, gas or silicone oil) and laser photocoagulation 67101 Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy 67105 Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation 67107 Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid 67108 Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique 67110 Repair of retinal detachment; by injection of air or other gas (e.g., pneumatic retinopexy) 67113 Repair of complex retinal detachment (e.g., proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens 67120 Removal of implanted material, posterior segment; extraocular 67121 Removal of implanted material, posterior segment; intraocular 67145 Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; photocoagulation 67210 Destruction of localized lesion of retina (e.g., macular edema, tumors), 1 or more sessions; photocoagulation 67218 Destruction of localized lesion of retina (e.g., macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source) 67220 Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photocoagulation (e.g., laser), 1 or more sessions 67221 Destruction of localized lesion of choroid (e.g., choroidal neovascularization); photodynamic therapy (includes intravenous infusion) 67228 Treatment of extensive or progressive retinopathy (e.g., diabetic retinopathy), photocoagulation 67311 Strabismus surgery, recession or resection procedure; 1 horizontal muscle 67312 Strabismus surgery, recession or resection procedure; 2 horizontal muscles 67314 Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique) 67316 Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique) 67318 Strabismus surgery, any procedure, superior oblique muscle 67345 Chemodenervation of extraocular muscle 67400 Orbitotomy without bone flap (frontal or transconjunctival approach); for exploration, with or without biopsy 67412 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of lesion
CPT Code Description Eye/Ocular Adnexa System 67414 Orbitotomy without bone flap (frontal or transconjunctival approach); with removal of bone for decompression 67420 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of lesion 67445 Orbitotomy with bone flap or window, lateral approach (e.g., Kroenlein); with removal of bone for decompression 67550 Orbital implant (implant outside muscle cone); insertion 67560 Orbital implant (implant outside muscle cone); removal or revision 67700 Blepharotomy, drainage of abscess, eyelid 67800 Excision of chalazion; single 67801 Excision of chalazion; multiple, same lid 67805 Excision of chalazion; multiple, different lids 67808 Excision of chalazion; under general anesthesia and/or requiring hospitalization, single or multiple 67840 Excision of lesion of eyelid (except chalazion) without closure or with simple direct closure 67875 Temporary closure of eyelids by suture (e.g., Frost suture) 67880 Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy 67935 Suture of recent wound, eyelid, involving lid margin, tarsus, and/or palpebral conjunctiva direct closure; full thickness 67938 Removal of embedded foreign body, eyelid 67971 Reconstruction of eyelid, full thickness by transfer of tarsconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage 67973 Reconstruction of eyelid, full thickness by transfer of tarsconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage 67975 Reconstruction of eyelid, full thickness by transfer of tarsconjunctival flap from opposing eyelid; second stage 68100 Biopsy of conjunctiva 68110 Excision of lesion, conjunctiva; up to 1 cm 68115 Excision of lesion, conjunctiva; over 1 cm 68135 Destruction of lesion, conjunctiva 68320 Conjunctivoplasty; with conjunctival graft or extensive rearrangement 68440 Snip incision of lacrimal punctum 68700 Plastic repair of canaliculi 68720 Dacryocystorhinostomy (Fistulization of lacrimal sac to nasal cavity) 68750 Conjunctivorhinostomy (Fistulization of conjunctiva to nasal cavity); with insertion of tube or stent 68811 Probing of nasolacrimal duct, with or without irrigation; requiring general anesthesia 68815 Probing of nasolacrimal duct, with or without irrigation; with insertion of tube or stent Female Genital System 56405 Incision and drainage of vulva or perineal abscess 56420 Incision and drainage of Bartholin’s gland abscess 56440 Marsupialization of Bartholin’s gland cyst 56441 Lysis of labial adhesions 56442 Hymenotomy, simple incision 56501 Destruction of lesion(s), vulva; simple (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) 56515 Destruction of lesion(s), vulva; extensive (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) 56605 Biopsy of vulva or perineum (separate procedure); 1 lesion
CPT Code Description Female Genital System 56620 Vulvectomy simple; partial 56700 Partial hymenectomy or revision of hymenal ring 56740 Excision of Bartholin’s gland or cyst 56810 Perineoplasty, repair of perineum, non-obstetrical (separate procedure) 56821 Colposcopy of the vulva; with biopsy(s) 57000 Colpotomy; with exploration 57061 Destruction of vaginal lesion(s); simple (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) 57065 Destruction of vaginal lesion(s); extensive (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery) 57100 Biopsy of vaginal mucosa; simple (separate procedure) 57105 Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) 57130 Excision of vaginal septum 57135 Excision of vaginal cyst or tumor 57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed 57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy 57260 Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed 57268 Repair of enterocele, vaginal approach (separate procedure) 57282 Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) 57283 Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) 57287 Removal or revision of sling for stress incontinence (e.g., fascia or synthetic) 57295 Revision (including removal) of prosthetic vaginal graft; vaginal approach 57300 Closure of rectovaginal fistula; vaginal or transanal approach 57410 Pelvic examination under anesthesia (other than local) 57415 Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) 57420 Colposcopy of the entire vagina, with cervix if present 57421 Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix 57425 Laparoscopy, surgical, colpopexy (suspension of vaginal apex) 57452 Colposcopy of the cervix including upper/adjacent vagina 57454 Colposcopy of the cervix including upper/adjacent vagina; with biopsy(s) of the cervix and endocervical curettage 57456 Colposcopy of the cervix including upper/adjacent vagina; with endocervical curettage 57461 Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix 57500 Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration (separate procedure) 57505 Endocervical curettage (not done as part of a dilation and curettage) 57510 Cautery of cervix; electro or thermal 57511 Cautery of cervix; cryocautery, initial or repeat 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 Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision 57530 Trachelectomy (cervicectomy), amputation of cervix (separate procedure)
CPT Code Description Female Genital System 57700 Cerclage of uterine cervix, non-obstetrical 57720 Trachelorrhaphy, plastic repair of uterine cervix, vaginal approach 57800 Dilation of cervical canal, instrumental (separate procedure) 58100 Endometrial sampling (biopsy) with or without endocervical sampling (biopsy), without cervical dilation, any method (separate procedure) 58120 Dilation and curettage, diagnostic and/or therapeutic (non-obstetrical) 58353 Endometrial ablation, thermal, without hysteroscopic guidance 58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D&C 58560 Hysteroscopy, surgical; with division or resection of intrauterine septum (any method) 58561 Hysteroscopy, surgical; with removal of leiomyomata 58562 Hysteroscopy, surgical; with removal of impacted foreign body 58563 Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation) 58565 Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants Hemic and Lymphatic Systems 38221 Diagnostic bone marrow; biopsy(ies) 38222 Diagnostic bone marrow; biopsy(ies) and aspiration(s) 38500 Biopsy or excision of lymph node(s); open, superficial 38505 Biopsy or excision of lymph node(s); by needle, superficial (e.g., cervical, inguinal, axillary) 38510 Biopsy or excision of lymph node(s); open, deep cervical node(s) 38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad 38525 Biopsy or excision of lymph node(s); open, deep axillary node(s) 38740 Axillary lymphadenectomy; superficial 38760 Inguinofemoral lymphadenectomy, superficial, including Cloquet’s node (separate procedure) Integumentary System 10121 Incision and removal of foreign body, subcutaneous tissues; complicated 10180 Incision and drainage, complex, postoperative wound infection 11010 Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin and subcutaneous tissues 11012 Debridement including removal of foreign material at the site of an open fracture and/or an open dislocation (e.g., excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle, and bone 11440 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less 11441 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm 11443 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm 11444 Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm 11446 Excision, other benign lesion including margins, except skin tag (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 11451 Excision of skin and subcutaneous tissue for hidradenitis, axillary; with complex repair
CPT Code Description Integumentary System 11462 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with simple or intermediate repair 11463 Excision of skin and subcutaneous tissue for hidradenitis, inguinal; with complex repair 11470 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair 11471 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair 11601 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm 11602 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm 11603 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm 11604 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm 11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less 11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm 11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm 11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm 11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm 11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less 11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm 11642 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm 11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm 11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm 11750 Excision of nail and nail matrix, partial or complete (e.g., ingrown or deformed nail), for permanent removal 11755 Biopsy of nail unit (e.g., plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure) 11760 Repair of nail bed 11770 Excision of pilonidal cyst or sinus; simple 11772 Excision of pilonidal cyst or sinus; complicated 12031 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.5 cm or less 12032 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm 12034 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm 12035 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm 12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less 12042 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm
CPT Code Description Integumentary System 12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less 12052 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm 13100 Repair, complex, trunk; 1.1 cm to 2.5 cm 13101 Repair, complex, trunk; 2.6 cm to 7.5 cm 13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm 13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm 13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm 13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm 13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm 14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq. cm or less 14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq. cm or less 14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq. cm to 60.0 sq. cm 15100 Split-thickness autograft, trunk, arms, legs; first 100 sq. cm or less, or 1% of body area of infants and children (except 15050) 15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq. cm or less, or 1% of body area of infants and children (except 15050) 15220 Full thickness graft, free, including direct closure of donor site, scalp, arms, and/or legs; 20 sq. cm or less 15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq. cm or less 15576 Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral 15760 Graft; composite (e.g., full thickness of external ear or nasal ala), including primary closure, donor area 15770 Graft; derma-fat-fascia 17000 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (e.g., actinic keratoses); first lesion 17004 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (e.g., actinic keratoses), 15 or more lesions 17106 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); less than 10 sq. cm 17107 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); 10.0 to 50.0 sq. cm 17108 Destruction of cutaneous vascular proliferative lesions (e.g., laser technique); over 50.0 sq. cm 17110 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions 17111 Destruction (e.g., laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions 17311 Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks
CPT Code Description Integumentary System 17313 Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (e.g., hematoxylin and eosin, toluidine blue), of the trunk, arms, or legs; first stage, up to 5 tissue blocks 19101 Biopsy of breast; open, incisional 19110 Nipple exploration, with or without excision of a solitary lactiferous duct or a papilloma lactiferous duct 19112 Excision of lactiferous duct fistula 19120 Excision of cyst, fibroadenoma, or other benign or malignant tumor, aberrant breast tissue, duct lesion, nipple or areolar lesion (except 19300), open, male or female, 1 or more lesions 19125 Excision of breast lesion identified by preoperative placement of radiological marker, open; single lesion 21552 Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater 21931 Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater Male Genital System 54001 Slitting of prepuce, dorsal or lateral (separate procedure); except newborn 54055 Destruction of lesion(s), penis (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation 54057 Destruction of lesion(s), penis (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery 54060 Destruction of lesion(s), penis (e.g., condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision 54065 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) 54161 Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age 54100 Biopsy of penis; (separate procedure) 54110 Excision of penile plaque (Peyronie disease) 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block 54162 Lysis or excision of penile post-circumcision adhesions 54163 Repair incomplete circumcision 54164 Frenulotomy of penis 54300 Plastic operation of penis for straightening of chordee (e.g., hypospadias), with or without mobilization of urethra 54360 Plastic operation on penis to correct angulation 54450 Foreskin manipulation including lysis of preputial adhesions and stretching 54512 Excision of extraparenchymal lesion of testis 54530 Orchiectomy, radical, for tumor; inguinal approach 54600 Reduction of torsion of testis, surgical, with or without fixation of contralateral testis 54620 Fixation of contralateral testis (separate procedure) 54640 Orchiopexy, inguinal approach, with or without hernia repair 54700 Incision and drainage of epididymis, testis and/or scrotal space (e.g., abscess or hematoma) 54830 Excision of local lesion of epididymis 54840 Excision of spermatocele, with or without epididymectomy 54860 Epididymectomy; unilateral 55040 Excision of hydrocele; unilateral 55041 Excision of hydrocele; bilateral 55060 Repair of tunica vaginalis hydrocele (Bottle type)
CPT Code
Description
Male Genital System
55100
Drainage of scrotal wall abscess
55110
Scrotal exploration
55120
Removal of foreign body in scrotum
55500
Excision of hydrocele of spermatic cord, unilateral (separate procedure)
55520
Excision of lesion of spermatic cord (separate procedure)
55540
Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair
Musculoskeletal System
20200
Biopsy, muscle; superficial
20205
Biopsy, muscle; deep
20220
Biopsy, bone, trocar, or needle; superficial (e.g., ilium, sternum, spinous process, ribs)
20225
Biopsy, bone, trocar, or needle; deep (e.g., vertebral body, femur)
20240
Biopsy, bone, open; superficial (e.g., sternum, spinous process, rib, patella, olecranon process, calcaneus, tarsal, metatarsal, carpal, metacarpal, phalanx)
20245
Biopsy, bone, open; deep (e.g., humeral shaft, ischium, femoral shaft)
20520
Removal of foreign body in muscle or tendon sheath; simple
20525
Removal of foreign body in muscle or tendon sheath; deep or complicated
20526
Injection, therapeutic (e.g., local anesthetic, corticosteroid), carpal tunnel
20551
Injection(s); single tendon origin/insertion
20600
Arthrocentesis, aspiration and/or injection, small joint or bursa (e.g., fingers, toes); without ultrasound guidance
20604
Arthrocentesis, aspiration and/or injection, small joint or bursa (e.g., fingers, toes); with ultrasound guidance, with permanent recording and reporting
20605
Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance
20606
Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (e.g., temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting
20610
Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); without ultrasound guidance
20611
Arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reporting
20612
Aspiration and/or injection of ganglion cyst(s) any location
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
20912
Cartilage graft; nasal septum
21011
Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm
21012
Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater
21013
Excision, tumor, soft tissue of face and scalp, subfascial (e.g., subgaleal, intramuscular); less than 2 cm
21014
Excision, tumor, soft tissue of face and scalp, subfascial (e.g., subgaleal, intramuscular); 2 cm or greater
21030
Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage
21031
Excision of torus mandibularis
21040
Excision of benign tumor or cyst of mandible, by enucleation and/or curettage
CPT Code
Description
Musculoskeletal System
21046
Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion[s])
21048
Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (e.g., locally aggressive or destructive lesion[s])
21315
Closed treatment of nasal bone fracture with manipulation; without stabilization
21325
Open treatment of nasal fracture; uncomplicated
21330
Open treatment of nasal fracture; complicated, with internal and/or external skeletal fixation
21335
Open treatment of nasal fracture; with concomitant open treatment of fractured septum
21336
Open treatment of nasal septal fracture, with or without stabilization
21337
Closed treatment of nasal septal fracture, with or without stabilization
21356
Open treatment of depressed zygomatic arch fracture (e.g., Gillies approach)
21550
Biopsy, soft tissue of neck or thorax
21555
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm
21556
Excision, tumor, soft tissue of neck or anterior thorax, subfascial (e.g., intramuscular); less than 5 cm
21557
Radical resection of tumor (e.g., sarcoma), soft tissue of neck or anterior thorax; less than 5 cm
21920
Biopsy, soft tissue of back or flank; superficial
21930
Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm
21932
Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); less than 5 cm
21933
Excision, tumor, soft tissue of back or flank, subfascial (e.g., intramuscular); 5 cm or greater
22513
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracic
22514
Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (e.g., kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbar
22900
Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); less than 5 cm
22901
Excision, tumor, soft tissue of abdominal wall, subfascial (e.g., intramuscular); 5 cm or greater
22902
Excision, tumor, soft tissue of abdominal wall, subcutaneous; less than 3 cm
22903
Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater
23071
Excision, tumor, soft tissue of shoulder area, subcutaneous; 3 cm or greater
23075
Excision, tumor, soft tissue of shoulder area, subcutaneous; less than 3 cm
23076
Excision, tumor, soft tissue of shoulder area, subfascial (e.g., intramuscular); less than 5 cm
23120
Claviculectomy; partial
23140
Excision or curettage of bone cyst or benign tumor of clavicle or scapula
23150
Excision or curettage of bone cyst or benign tumor of proximal humerus
23405
Tenotomy, shoulder area; single tendon
23415
Coracoacromial ligament release, with or without acromioplasty
23430
Tenodesis of long tendon of biceps
23440
Resection or transplantation of long tendon of biceps
23480
Osteotomy, clavicle, with or without internal fixation
23615
Open treatment of proximal humeral (surgical or anatomical neck) fracture, includes internal fixation, when performed, includes repair of tuberosity(s), when performed
23630
Open treatment of greater humeral tuberosity fracture, includes internal fixation, when performed
23700
Manipulation under anesthesia, shoulder joint, including application of fixation apparatus (dislocation excluded)
CPT Code Description Musculoskeletal System 24000 Arthrotomy, elbow, including exploration, drainage, or removal of foreign body 24006 Arthrotomy of the elbow, with capsular excision for capsular release (separate procedure) 24065 Biopsy, soft tissue of upper arm or elbow area; superficial 24066 Biopsy, soft tissue of upper arm or elbow area; deep (subfascial or intramuscular) 24071 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; 3 cm or greater 24073 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (e.g., intramuscular); 5 cm or greater 24075 Excision, tumor, soft tissue of upper arm or elbow area, subcutaneous; less than 3 cm 24076 Excision, tumor, soft tissue of upper arm or elbow area, subfascial (e.g., intramuscular); less than 5 cm 24101 Arthrotomy, elbow; with joint exploration, with or without biopsy, with or without removal of loose or foreign body 24102 Arthrotomy, elbow; with synovectomy 24105 Excision, olecranon bursa 24110 Excision or curettage of bone cyst or benign tumor, humerus 24120 Excision or curettage of bone cyst or benign tumor of head or neck of radius or olecranon process 24130 Excision, radial head 24147 Partial excision (craterization, saucerization, or diaphysectomy) bone (e.g., osteomyelitis), olecranon process 24200 Removal of foreign body, upper arm or elbow area; subcutaneous 24201 Removal of foreign body, upper arm or elbow area; deep (subfascial or intramuscular) 24300 Manipulation, elbow, under anesthesia 24310 Tenotomy, open, elbow to shoulder, each tendon 24340 Tenodesis of biceps tendon at elbow (separate procedure) 24341 Repair, tendon or muscle, upper arm or elbow, each tendon or muscle, primary or secondary (excludes rotator cuff) 24342 Reinsertion of ruptured biceps or triceps tendon, distal, with or without tendon graft 24343 Repair lateral collateral ligament, elbow, with local tissue 24357 Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer’s elbow); percutaneous 24358 Tenotomy, elbow, lateral or medial (e.g., epicondylitis, tennis elbow, golfer’s elbow); debridement, soft tissue and/or bone, open 24366 Arthroplasty, radial head; with implant 24515 Open treatment of humeral shaft fracture with plate/screws, with or without cerclage 24516 Treatment of humeral shaft fracture, with insertion of intramedullary implant, with or without cerclage and/or locking screws 24586 Open treatment of periarticular fracture and/or dislocation of the elbow (fracture distal humerus and proximal ulna and/or proximal radius) 24615 Open treatment of acute or chronic elbow dislocation 24665 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed 24666 Open treatment of radial head or neck fracture, includes internal fixation or radial head excision, when performed; with radial head prosthetic replacement 25000 Incision, extensor tendon sheath, wrist (e.g., deQuervains disease) 25071 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; 3 cm or greater 25073 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (e.g., intramuscular); 3 cm or greater 25075 Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm
CPT Code Description Musculoskeletal System 25076 Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (e.g., intramuscular); less than 3 cm 25085 Capsulotomy, wrist (e.g., contracture) 25105 Arthrotomy, wrist joint; with synovectomy 25107 Arthrotomy, distal radioulnar joint including repair of triangular cartilage, complex 25109 Excision of tendon, forearm and/or wrist, flexor or extensor, each 25110 Excision, lesion of tendon sheath, forearm and/or wrist 25111 Excision of ganglion, wrist (dorsal or volar); primary 25112 Excision of ganglion, wrist (dorsal or volar); recurrent 25115 Radical excision of bursa, synovia of wrist, or forearm tendon sheaths (eg, tenosynovitis, fungus, Tbc, or other granulomas, rheumatoid arthritis); flexors 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) 25130 Excision or curettage of bone cyst or benign tumor of carpal bones 25151 Partial excision (craterization, saucerization, or diaphysectomy) of bone (e.g., for osteomyelitis); radius 25210 Carpectomy; 1 bone 25215 Carpectomy; all bones of proximal row 25230 Radial styloidectomy (separate procedure) 25240 Excision distal ulna partial or complete (e.g., Darrach type or matched resection) 25260 Repair, tendon or muscle, flexor, forearm and/or wrist; primary, single, each tendon or muscle 25270 Repair, tendon or muscle, extensor, forearm and/or wrist; primary, single, each tendon or muscle 25275 Repair, tendon sheath, extensor, forearm and/or wrist, with free graft (includes obtaining graft) (e.g., for extensor carpi ulnaris subluxation) 25280 Lengthening or shortening of flexor or extensor tendon, forearm and/or wrist, single, each tendon 25290 Tenotomy, open, flexor or extensor tendon, forearm and/or wrist, single, each tendon 25295 Tenolysis, flexor or extensor tendon, forearm and/or wrist, single, each tendon 25350 Osteotomy, radius; distal third 25445 Arthroplasty with prosthetic replacement; trapezium 25545 Open treatment of ulnar shaft fracture, includes internal fixation, when performed 25605 Closed treatment of distal radial fracture (e.g., Colles or Smith type) or epiphyseal separation, includes closed treatment of fracture of ulnar styloid, when performed; 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 Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragments 25624 Closed treatment of carpal scaphoid (navicular) fracture; with manipulation 25628 Open treatment of carpal scaphoid (navicular) fracture, includes internal fixation, when performed 25645 Open treatment of carpal bone fracture (other than carpal scaphoid [navicular]), each bone 25652 Open treatment of ulnar styloid fracture 25810 Arthrodesis, wrist; with iliac or other autograft (includes obtaining graft) 25825 Arthrodesis, wrist; with autograft (includes obtaining graft) 26011 Drainage of finger abscess; complicated (e.g., felon)
CPT Code Description Musculoskeletal System 26020 Drainage of tendon sheath, digit and/or palm, each 26045 Fasciotomy, palmar (e.g., Dupuytren’s contracture); 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 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; metacarpophalangeal joint, each 26080 Arthrotomy, with exploration, drainage, or removal of loose or foreign body; interphalangeal joint, each 26105 Arthrotomy with biopsy; metacarpophalangeal joint, each 26110 Arthrotomy with biopsy; interphalangeal joint, each 26111 Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater 26113 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (e.g., intramuscular); 1.5 cm or greater 26115 Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm 26116 Excision, tumor, soft tissue, or vascular malformation, of hand or finger, subfascial (e.g., intramuscular); less than 1.5 cm 26121 Fasciectomy, palm only, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) 26123 Fasciectomy, partial palmar with release of single digit including proximal interphalangeal joint, with or without Z-plasty, other local tissue rearrangement, or skin grafting (includes obtaining graft) 26160 Excision of lesion of tendon sheath or joint capsule (e.g., cyst, mucous cyst, or ganglion), hand or finger 26180 Excision of tendon, finger, flexor or extensor, each tendon 26200 Excision or curettage of bone cyst or benign tumor of metacarpal 26210 Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger 26215 Excision or curettage of bone cyst or benign tumor of proximal, middle, or distal phalanx of finger; with autograft (includes obtaining graft) 26236 Partial excision (craterization, saucerization, or diaphysectomy) bone (e.g., osteomyelitis); distal phalanx of finger 26320 Removal of implant from finger or hand 26350 Repair or advancement, flexor tendon, not in zone 2 digital flexor tendon sheath (eg, no man’s land); primary or secondary without free graft, each tendon 26356 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (e.g., no man’s land); primary, without free graft, each tendon 26357 Repair or advancement, flexor tendon, in zone 2 digital flexor tendon sheath (e.g., no man’s land); secondary, without free graft, each tendon 26392 Removal of synthetic rod and insertion of flexor tendon graft, hand or finger (includes obtaining graft), each rod 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 26420 Repair, extensor tendon, finger, primary or secondary; with free graft (includes obtaining graft) each tendon 26426 Repair of extensor tendon, central slip, secondary (e.g., boutonniere deformity); using local tissue(s), including lateral band(s), each finger 26432 Closed treatment of distal extensor tendon insertion, with or without percutaneous pinning (e.g., mallet finger)
CPT Code Description Musculoskeletal System 26433 Repair of extensor tendon, distal insertion, primary or secondary; without graft (e.g., mallet finger) 26437 Realignment of extensor tendon, hand, each tendon 26440 Tenolysis, flexor tendon; palm or finger, each tendon 26442 Tenolysis, flexor tendon; palm and finger, each tendon 26445 Tenolysis, extensor tendon, hand or finger, each tendon 26455 Tenotomy, flexor, finger, open, each tendon 26480 Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendon 26500 Reconstruction of tendon pulley, each tendon; with local tissues (separate procedure) 26502 Reconstruction of tendon pulley, each tendon; with tendon or fascial graft (includes obtaining graft) (separate procedure) 26516 Capsulodesis, metacarpophalangeal joint; single digit 26520 Capsulectomy or capsulotomy; metacarpophalangeal joint, each joint 26525 Capsulectomy or capsulotomy; interphalangeal joint, each joint 26530 Arthroplasty, metacarpophalangeal joint; each joint 26535 Arthroplasty, interphalangeal joint; each joint 26540 Repair of collateral ligament, metacarpophalangeal or interphalangeal joint 26541 Reconstruction, collateral ligament, metacarpophalangeal joint, single; with tendon or fascial graft (includes obtaining graft) 26542 Reconstruction, collateral ligament, metacarpophalangeal joint, single; with local tissue (e.g., adductor advancement) 26567 Osteotomy; phalanx of finger, each 26608 Percutaneous skeletal fixation of metacarpal fracture, each bone 26615 Open treatment of metacarpal fracture, single, includes internal fixation, when performed, each bone 26650 Percutaneous skeletal fixation of carpometacarpal fracture dislocation, thumb (Bennett fracture), with manipulation 26665 Open treatment of carpometacarpal fracture dislocation, thumb (Bennett fracture), includes internal fixation, when performed 26676 Percutaneous skeletal fixation of carpometacarpal dislocation, other than thumb, with manipulation, each joint 26715 Open treatment of metacarpophalangeal dislocation, single, includes internal fixation, when performed 26727 Percutaneous skeletal fixation of unstable phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, with manipulation, each 26735 Open treatment of phalangeal shaft fracture, proximal or middle phalanx, finger or thumb, includes internal fixation, when performed, each 26742 Closed treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint; with manipulation, each 26746 Open treatment of articular fracture, involving metacarpophalangeal or interphalangeal joint, includes internal fixation, when performed, each 26756 Percutaneous skeletal fixation of distal phalangeal fracture, finger or thumb, each 26765 Open treatment of distal phalangeal fracture, finger or thumb, includes internal fixation, when performed, each 26841 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation 26842 Arthrodesis, carpometacarpal joint, thumb, with or without internal fixation; with autograft (includes obtaining graft) 26850 Arthrodesis, metacarpophalangeal joint, with or without internal fixation
CPT Code Description Musculoskeletal System 26860 Arthrodesis, interphalangeal joint, with or without internal fixation 26862 Arthrodesis, interphalangeal joint, with or without internal fixation; with autograft (includes obtaining graft) 26910 Amputation, metacarpal, with finger or thumb (ray amputation), single, with or without interosseous transfer 26951 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with direct closure 26952 Amputation, finger or thumb, primary or secondary, any joint or phalanx, single, including neurectomies; with local advancement flaps (V-Y, hood) 27043 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; 3 cm or greater 27045 Excision, tumor, soft tissue of pelvis and hip area, subfascial (e.g., intramuscular); 5 cm or greater 27047 Excision, tumor, soft tissue of pelvis and hip area, subcutaneous; less than 3 cm 27048 Excision, tumor, soft tissue of pelvis and hip area, subfascial (e.g., intramuscular); less than 5 cm 27062 Excision; trochanteric bursa or calcification 27093 Injection procedure for hip arthrography; without anesthesia 27095 Injection procedure for hip arthrography; with anesthesia 27310 Arthrotomy, knee, with exploration, drainage, or removal of foreign body (e.g., infection) 27323 Biopsy, soft tissue of thigh or knee area; superficial 27324 Biopsy, soft tissue of thigh or knee area; deep (subfascial or intramuscular) 27327 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; less than 3 cm 27328 Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); less than 5 cm 27329 Radical resection of tumor (e.g., sarcoma), soft tissue of thigh or knee area; less than 5 cm 27331 Arthrotomy, knee; including joint exploration, biopsy, or removal of loose or foreign bodies 27332 Arthrotomy, with excision of semilunar cartilage (meniscectomy) knee; medial or lateral 27334 Arthrotomy, with synovectomy, knee; anterior or posterior 27335 Arthrotomy, with synovectomy, knee; anterior and posterior including popliteal area 27337 Excision, tumor, soft tissue of thigh or knee area, subcutaneous; 3 cm or greater 27339 Excision, tumor, soft tissue of thigh or knee area, subfascial (e.g., intramuscular); 5 cm or greater 27340 Excision, prepatellar bursa 27345 Excision of synovial cyst of popliteal space (e.g., Baker’s cyst) 27347 Excision of lesion of meniscus or capsule (e.g., cyst, ganglion), knee 27372 Removal of foreign body, deep, thigh region or knee area 27403 Arthrotomy with meniscus repair, knee 27407 Repair, primary, torn ligament and/or capsule, knee; cruciate 27418 Anterior tibial tubercleplasty (e.g., Maquet type procedure) 27570 Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices) 27606 Tenotomy, percutaneous, Achilles tendon (separate procedure); general anesthesia 27613 Biopsy, soft tissue of leg or ankle area; superficial 27614 Biopsy, soft tissue of leg or ankle area; deep (subfascial or intramuscular) 27618 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; less than 3 cm 27619 Excision, tumor, soft tissue of leg or ankle area, subfascial (e.g., intramuscular); less than 5 cm 27620 Arthrotomy, ankle, with joint exploration, with or without biopsy, with or without removal of loose or foreign body 27626 Arthrotomy, with synovectomy, ankle; including tenosynovectomy
CPT Code Description Musculoskeletal System 27632 Excision, tumor, soft tissue of leg or ankle area, subcutaneous; 3 cm or greater 27634 Excision, tumor, soft tissue of leg or ankle area, subfascial (e.g., intramuscular); 5 cm or greater 27638 Excision or curettage of bone cyst or benign tumor, tibia or fibula; with allograft 27640 Partial excision (craterization, saucerization, or diaphysectomy), bone (e.g., osteomyelitis); tibia 27658 Repair, flexor tendon, leg; primary, without graft, each tendon 27659 Repair, flexor tendon, leg; secondary, with or without graft, each tendon 27665 Repair, extensor tendon, leg; secondary, with or without graft, each tendon 27680 Tenolysis, flexor or extensor tendon, leg and/or ankle; single, each tendon 27685 Lengthening or shortening of tendon, leg or ankle; single tendon (separate procedure) 27690 Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot) 27696 Repair, primary, disrupted ligament, ankle; both collateral ligaments 27705 Osteotomy; tibia 27720 Repair of nonunion or malunion, tibia; without graft, (e.g., compression technique) 27756 Percutaneous skeletal fixation of tibial shaft fracture (with or without fibular fracture) (e.g., pins or screws) 27788 Closed treatment of distal fibular fracture (lateral malleolus); with manipulation 28005 Incision, bone cortex (e.g., osteomyelitis or bone abscess), foot 28010 Tenotomy, percutaneous, toe; single tendon 28011 Tenotomy, percutaneous, toe; multiple tendons 28020 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; intertarsal or tarsometatarsal joint 28022 Arthrotomy, including exploration, drainage, or removal of loose or foreign body; metatarsophalangeal joint 28035 Release, tarsal tunnel (posterior tibial nerve decompression) 28039 Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater 28041 Excision, tumor, soft tissue of foot or toe, subfascial (e.g., intramuscular); 1.5 cm or greater 28043 Excision, tumor, soft tissue of foot or toe, subcutaneous; less than 1.5 cm 28045 Excision, tumor, soft tissue of foot or toe, subfascial (e.g., intramuscular); less than 1.5 cm 28047 Radical resection of tumor (e.g., sarcoma), soft tissue of foot or toe; 3 cm or greater 28055 Neurectomy, intrinsic musculature of foot 28060 Fasciectomy, plantar fascia; partial (separate procedure) 28080 Excision, interdigital (Morton) neuroma, single, each 28086 Synovectomy, tendon sheath, foot; flexor 28088 Synovectomy, tendon sheath, foot; extensor 28090 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); foot 28092 Excision of lesion, tendon, tendon sheath, or capsule (including synovectomy) (e.g., cyst or ganglion); toe(s), each 28100 Excision or curettage of bone cyst or benign tumor, talus or calcaneus 28103 Excision or curettage of bone cyst or benign tumor, talus or calcaneus; with allograft 28104 Excision or curettage of bone cyst or benign tumor, tarsal or metatarsal, except talus or calcaneus 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
CPT Code
Description
Musculoskeletal System
28112
Ostectomy, complete excision; other metatarsal head (second, third or fourth)
28113
Ostectomy, complete excision; fifth metatarsal head
28118
Ostectomy, calcaneus
28119
Ostectomy, calcaneus; for spur, with or without plantar fascial release
28120
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); talus or calcaneus
28122
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (eg, osteomyelitis or bossing); tarsal or metatarsal bone, except talus or calcaneus
28124
Partial excision (craterization, saucerization, sequestrectomy, or diaphysectomy) bone (e.g., osteomyelitis or bossing); phalanx of toe
28126
Resection, partial or complete, phalangeal base, each toe
28153
Resection, condyle(s), distal end of phalanx, each toe
28160
Hemiphalangectomy or interphalangeal joint excision, toe, proximal end of phalanx, each
28190
Removal of foreign body, foot; subcutaneous
28192
Removal of foreign body, foot; deep
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
28225
Tenolysis, extensor, foot; single tendon
28232
Tenotomy, open, tendon flexor; toe, single tendon (separate procedure)
28234
Tenotomy, open, extensor, foot or toe, each tendon
28238
Reconstruction (advancement), posterior tibial tendon with excision of accessory tarsal navicular bone (eg, Kidner type procedure)
28250
Division of plantar fascia and muscle (e.g., Steindler stripping) (separate procedure)
28272
Capsulotomy; interphalangeal joint, each joint (separate procedure)
28280
Syndactylization, toes (e.g., webbing or Kelikian type procedure)
28285
Correction, hammertoe (e.g., interphalangeal fusion, partial or total phalangectomy)
28286
Correction, cock-up fifth toe, with plastic skin closure (e.g., Ruiz-Mora type procedure)
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; without implant
28291
Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant
28292
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any method
28295
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal metatarsal osteotomy, any method
28296
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any method
28297
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any method
28298
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any method
28299
Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any method
28306
Osteotomy, with or without lengthening, shortening or angular correction, metatarsal; first metatarsal
CPT Code
Description
Musculoskeletal System
28310
Osteotomy, shortening, angular or rotational correction; proximal phalanx, first toe (separate procedure)
28312
Osteotomy, shortening, angular or rotational correction; other phalanges, any toe
28313
Reconstruction, angular deformity of toe, soft tissue procedures only (e.g., overlapping second toe, fifth toe, curly toes)
28315
Sesamoidectomy, first toe (separate procedure)
28322
Repair, nonunion or malunion; metatarsal, with or without bone graft (includes obtaining graft)
28475
Closed treatment of metatarsal fracture; with manipulation, each
28476
Percutaneous skeletal fixation of metatarsal fracture, with manipulation, each
28496
Percutaneous skeletal fixation of fracture great toe, phalanx or phalanges, with manipulation
28515
Closed treatment of fracture, phalanx or phalanges, other than great toe; with manipulation, each
28525
Open treatment of fracture, phalanx or phalanges, other than great toe, includes internal fixation, when performed, each
28645
Open treatment of metatarsophalangeal joint dislocation, includes internal fixation, when performed
28666
Percutaneous skeletal fixation of interphalangeal joint dislocation, with manipulation
28675
Open treatment of interphalangeal joint dislocation, includes internal fixation, when performed
28755
Arthrodesis, great toe; interphalangeal joint
28760
Arthrodesis, with extensor hallucis longus transfer to first metatarsal neck, great toe, interphalangeal joint (e.g., Jones type procedure)
28810
Amputation, metatarsal, with toe, single
28825
Amputation, toe; interphalangeal joint
29800
Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)
29804
Arthroscopy, temporomandibular joint, surgical
29805
Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)
29806
Arthroscopy, shoulder, surgical; Capsulorrhaphy
29807
Arthroscopy, shoulder, surgical; repair of SLAP lesion
29819
Arthroscopy, shoulder, surgical; with removal of loose body or foreign body
29820
Arthroscopy, shoulder, surgical; synovectomy, partial
29821
Arthroscopy, shoulder, surgical; synovectomy, complete
29822
Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
29823
Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (e.g., humeral bone, humeral articular cartilage, glenoid bone, glenoid articular cartilage, biceps tendon, biceps anchor complex, labrum, articular capsule, articular side of the rotator cuff, bursal side of the rotator cuff, subacromial bursa, foreign body[ies])
29824
Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)
29825
Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulation
29827
Arthroscopy, shoulder, surgical; with rotator cuff repair
29828
Arthroscopy, shoulder, surgical; biceps tenodesis
29830
Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)
29834
Arthroscopy, elbow, surgical; with removal of loose body or foreign body
29835
Arthroscopy, elbow, surgical; synovectomy, partial
29836
Arthroscopy, elbow, surgical; synovectomy, complete
CPT Code
Description
Musculoskeletal System
29837
Arthroscopy, elbow, surgical; debridement, limited
29838
Arthroscopy, elbow, surgical; debridement, extensive
29840
Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)
29844
Arthroscopy, wrist, surgical; synovectomy, partial
29845
Arthroscopy, wrist, surgical; synovectomy, complete
29846
Arthroscopy, wrist, surgical; excision and/or repair of triangular fibrocartilage and/or joint debridement
29847
Arthroscopy, wrist, surgical; internal fixation for fracture or instability
29848
Endoscopy, wrist, surgical, with release of transverse carpal ligament
29860
Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)
29861
Arthroscopy, hip, surgical; with removal of loose body or foreign body
29862
Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrum
29863
Arthroscopy, hip, surgical; with synovectomy
29870
Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)
29873
Arthroscopy, knee, surgical; with lateral release
29874
Arthroscopy, knee, surgical; for removal of loose body or foreign body (e.g., osteochondritis dissecans fragmentation, chondral fragmentation)
29875
Arthroscopy, knee, surgical; synovectomy, limited (e.g., plica or shelf resection) (separate procedure)
29876
Arthroscopy, knee, surgical; synovectomy, major, two or more compartments (e.g., medial or lateral)
29877
Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)
29879
Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfracture
29880
Arthroscopy, knee, surgical; with meniscectomy (medial and lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
29881
Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performed
29882
Arthroscopy, knee, surgical; with meniscus repair (medial or lateral)
29883
Arthroscopy, knee, surgical; with meniscus repair (medial and lateral)
29884
Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)
29885
Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)
29886
Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion
29887
Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixation
29888
Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstruction
29889
Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstruction
29891
Arthroscopy, ankle, surgical; excision of osteochondral defect of talus and/or tibia, including drilling of the defect
29892
Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)
29893
Endoscopic plantar fasciotomy
29894
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign body
CPT Code
Description
Musculoskeletal System
29895
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partial
29897
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limited
29898
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensive
29899
Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesis
29900
Arthroscopy, metacarpophalangeal joint, diagnostic, includes synovial biopsy
29901
Arthroscopy, metacarpophalangeal joint, surgical; with debridement
29902
Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, Stenar lesion)
29906
Arthroscopy, subtalar joint, surgical; with debridement
29914
Arthroscopy, hip, surgical; with femoroplasty (i.e., treatment of cam lesion)
29915
Arthroscopy, hip, surgical; with acetabuloplasty (i.e., treatment of pincer lesion)
29916
Arthroscopy, hip, surgical; with labral repair
G0260
Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent and arthrography
Nervous System
62281
Injection/infusion of neurolytic substance (e.g., alcohol, phenol, iced saline solutions), with or without other therapeutic substance; epidural, cervical or thoracic
63661
Removal of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
63663
Revision including replacement, when performed, of spinal neurostimulator electrode percutaneous array(s), including fluoroscopy, when performed
64425
Injection(s), anesthetic agent(s) and/or steroid; ilioinguinal, iliohypogastric nerves
64530
Injection, anesthetic agent; celiac plexus, with or without radiologic monitoring
64561
Percutaneous implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) including image guidance, if performed
64581
Open implantation of neurostimulator electrode array; sacral nerve (transforaminal placement)
64585
Revision or removal of peripheral neurostimulator electrode array
64600
Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch
64610
Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring
64642
Chemodenervation of one extremity; 1-4 muscle(s)
64644
Chemodenervation of one extremity; 5 or more muscles
64646
Chemodenervation of trunk muscle(s); 1-5 muscle(s)
64647
Chemodenervation of trunk muscle(s); 6 or more muscles
64702
Neuroplasty; digital, 1 or both, same digit
64718
Neuroplasty and/or transposition; ulnar nerve at elbow
64719
Neuroplasty and/or transposition; ulnar nerve at wrist
64721
Neuroplasty and/or transposition; median nerve at carpal tunnel
64774
Excision of neuroma; cutaneous nerve, surgically identifiable
64776
Excision of neuroma; digital nerve, 1 or both, same digit
64782
Excision of neuroma; hand or foot, except digital nerve
64784
Excision of neuroma; major peripheral nerve, except sciatic
64788
Excision of neurofibroma or neurolemmoma; cutaneous nerve
64795
Biopsy of nerve
64831
Suture of digital nerve, hand or foot; 1 nerve
CPT Code Description Nervous System 64835 Suture of 1 nerve; median motor thenar Respiratory System 21320 Closed treatment of nasal bone fracture with manipulation; with stabilization 30000 Drainage abscess or hematoma, nasal, internal approach 30020 Drainage abscess or hematoma, nasal septum 30100 Biopsy, intranasal 30110 Excision, nasal polyp(s), simple 30115 Excision, nasal polyp(s), extensive 30118 Excision or destruction (e.g., laser), intranasal lesion; external approach (lateral rhinotomy) 30130 Excision inferior turbinate, partial or complete, any method 30140 Submucous resection inferior turbinate, partial or complete, any method 30220 Insertion, nasal septal prosthesis (button) 30310 Removal foreign body, intranasal; requiring general anesthesia 30520 Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft 30580 Repair fistula; oromaxillary (combine with 31030 if antrotomy is included) 30630 Repair nasal septal perforations 30801 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (e.g., electrocautery, radiofrequency ablation, or tissue volume reduction); superficial 30802 Ablation, soft tissue of inferior turbinates, unilateral or bilateral, any method (e.g., electrocautery, radiofrequency ablation, or tissue volume reduction); intramural (i.e., submucosal) 30930 Fracture nasal inferior turbinate(s), therapeutic 31020 Sinusotomy, maxillary (antrotomy); intranasal 31030 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps 31032 Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps 31200 Ethmoidectomy; intranasal, anterior 31205 Ethmoidectomy; extranasal, total 31525 Laryngoscopy direct, with or without tracheoscopy; diagnostic, except newborn 31526 Laryngoscopy direct, with or without tracheoscopy; diagnostic, with operating microscope or telescope 31528 Laryngoscopy direct, with or without tracheoscopy; with dilation, initial 31529 Laryngoscopy direct, with or without tracheoscopy; with dilation, subsequent 31530 Laryngoscopy, direct, operative, with foreign body removal 31535 Laryngoscopy, direct, operative, with biopsy 31536 Laryngoscopy, direct, operative, with biopsy; with operating microscope or telescope 31540 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis 31541 Laryngoscopy, direct, operative, with excision of tumor and/or stripping of vocal cords or epiglottis; with operating microscope or telescope 31545 Laryngoscopy, direct, operative, with operating microscope or telescope, with submucosal removal of non-neoplastic lesion(s) of vocal cord; reconstruction with local tissue flap(s) 31570 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic 31571 Laryngoscopy, direct, with injection into vocal cord(s), therapeutic; with operating microscope or telescope 31574 Laryngoscopy, flexible; with injection(s) for augmentation (e.g., percutaneous, transoral), unilateral 31575 Laryngoscopy, flexible; diagnostic 31576 Laryngoscopy, flexible; with biopsy(ies)
CPT Code Description Respiratory System 31578 Laryngoscopy, flexible; with removal of lesion(s), non-laser 31591 Laryngoplasty, medialization, unilateral 31611 Construction of tracheoesophageal fistula and subsequent insertion of an alaryngeal speech prosthesis (e.g., voice button, Blom-Singer prosthesis) 31622 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; diagnostic, with cell washing, when performed (separate procedure) 31623 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with brushing or protected brushings 31624 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial alveolar lavage 31625 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with bronchial or endobronchial biopsy(s), single or multiple sites 31628 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with transbronchial lung biopsy(s), single lobe 31652 Bronchoscopy, rigid or flexible, including fluoroscopic guidance, when performed; with endobronchial ultrasound (EBUS) guided transtracheal and/or transbronchial sampling (e.g., aspiration[s]/biopsy[ies]), one or two mediastinal and/or hilar lymph node stations or structures 32408 Core needle biopsy, lung or mediastinum, percutaneous, including imaging guidance, when performed 32555 Thoracentesis, needle or catheter, aspiration of the pleural space; with imaging guidance 32557 Pleural drainage, percutaneous, with insertion of indwelling catheter; with imaging guidance Urinary System 50430 Injection procedure for antegrade nephrostogram and/or ureterogram, complete diagnostic procedure including imaging guidance (e.g., ultrasound and fluoroscopy) and all associated radiological supervision and interpretation; new access 50435 Exchange nephrostomy catheter, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (e.g., ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation 50575 Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent) 50590 Lithotripsy, extracorporeal shock wave 50688 Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit 51102 Aspiration of bladder; with insertion of suprapubic catheter 51702 Insertion of temporary indwelling bladder catheter; simple (e.g., Foley) 51710 Change of cystostomy tube; complicated 51715 Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck 51720 Bladder instillation of anticarcinogenic agent (including retention time) 51726 Complex cystometrogram (i.e., calibrated electronic equipment) 51728 Complex cystometrogram (i.e., calibrated electronic equipment); with voiding pressure studies (i.e., bladder voiding pressure), any technique 51729 Complex cystometrogram (i.e., calibrated electronic equipment); with voiding pressure studies (i.e., bladder voiding pressure) and urethral pressure profile studies (i.e., urethral closure pressure profile), any technique 52000 Cystourethroscopy (separate procedure) 52001 Cystourethroscopy with irrigation and evacuation of multiple obstructing clots
CPT Code
Description
Urinary System
52005
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service
52007
Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis
52204
Cystourethroscopy, with biopsy(s)
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 up to 2.0 cm)
52235
Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; medium bladder tumor(s) (2.0 to 5.0 cm)
52260
Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia
52265
Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia
52275
Cystourethroscopy, with internal urethrotomy; male
52276
Cystourethroscopy with direct vision internal urethrotomy
52281
Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female
52282
Cystourethroscopy, with insertion of permanent urethral stent
52283
Cystourethroscopy, with steroid injection into stricture
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
52287
Cystourethroscopy, with injection(s) for Chemodenervation of the bladder
52300
Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral
52310
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple
52315
Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated
52317
Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)
52320
Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus
52325
Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (e.g., ultrasonic or electro-hydraulic technique)
52327
Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material
52330
Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus
52332
Cystourethroscopy, with insertion of indwelling ureteral stent (e.g., Gibbons or double-J type)
52341
Cystourethroscopy; with treatment of ureteral stricture (e.g., balloon dilation, laser, electrocautery, and incision)
52344
Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (e.g., balloon dilation, laser, electrocautery, and incision)
52351
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic
52352
Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included)
CPT Code Description Urinary System 52353 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) 52354 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion 52356 Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (e.g., Gibbons or double-J type) 52450 Transurethral incision of prostate 52500 Transurethral resection of bladder neck (separate procedure) 52630 Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52640 Transurethral resection; of postoperative bladder neck contracture 53020 Meatotomy, cutting of meatus (separate procedure); except infant 53230 Excision of urethral diverticulum (separate procedure); female 53260 Excision or fulguration; urethral polyp(s), distal urethra 53265 Excision or fulguration; urethral caruncle 53270 Excision or fulguration; Skene’s glands 53440 Sling operation for correction of male urinary incontinence (e.g., fascia or synthetic) 53445 Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff 53450 Urethromeatoplasty, with mucosal advancement 53605 Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia 53665 Dilation of female urethra, general or conduction (spinal) anesthesia CPT® is a registered trademark of the American Medical Association Outpatient Surgical Procedures - Site of Service: CPT/HCPCS Codes Page 29 of 29 UnitedHealthcare Policy Appendix: Applicable Code List for Commercial plans Effective 01/01/2026 Proprietary Information of UnitedHealthcare. Copyright 2026 United HealthCare Services, Inc.