Attachment Q CCN Utilization Review Code List.xlsx

XLSX spreadsheet 114 KB Posted

Attached to
Q201--CCN-Next Gen Medical
Solicitation number
36C10G26R0003
Issued by

About this file

This file is an attachment listing Current Procedural Terminology (CPT) codes for ambulatory and surgical procedures, specifically a comprehensive catalog of medical service codes categorized across multiple specialties. The extensive document includes detailed CPT codes for procedures in areas such as cardiac surgery, orthopedics, neurology, oncology, imaging, radiation therapy, endoscopy, infusion therapy, and genetic testing, with each code indicating whether the procedure requires physician supervision (marked with Y or N).

The attachment provides a granular breakdown of medical services with corresponding codes, allowing precise medical billing and procedural documentation. Each CPT code includes specific details like the type of medical procedure, the anatomical region involved, and whether the procedure requires specialized equipment or techniques. The codes are organized systematically by medical specialty and procedure complexity, ranging from simple diagnostic procedures to complex surgical interventions, and include both invasive and non-invasive medical services across multiple healthcare domains.

View the file

Other files

File Type Posted
CCN Next Gen - Medical TOPR East 36C10G26R0003 0001-15 Amendment.pdf PDF
Attachment 3 - CCN Next Gen Medical - West TOPR Price Schedule v6.xlsx XLSX spreadsheet
36C10G26R0003 0021 CCN Next Gen - Medical Amendment.pdf PDF
Attachment C - Performance Requirement Summary_Medical West_04_10_26_v4.pdf PDF
CCN Next Gen - Medical TOPR East 36C10G26R0003 0001-13 Amendment.pdf PDF
36C10G26R0003 0020 CCN Next Gen - Medical Amendment.pdf PDF
CCN Next Gen - Medical TOPR West 0002-12 Amendment.pdf PDF
Attachment 1 - CCN Next Gen Medical - West TOPR 0002 PWS _04_02_2026 v4.pdf PDF
CCN Next Gen Medical Open Mic Session Recording.mp4 MP4 file
Attachment 3 - CCN Next Gen - Medical West TOPR Price Schedule v4.xlsx XLSX spreadsheet
CCN Next Gen - Medical TOPR East 0001-09 Amendment.pdf PDF
36C10G26R0003 Next Gen - Medical Conformed Copy 03272026.pdf PDF
36C10G26R0003 0014 CCN Next Gen - Medical Amendment.pdf PDF
Attachment 3 - CCN Next Gen - Medical East TOPR Price Schedule v4.xlsx XLSX spreadsheet
CCN Next Gen - Medical TOPR West 0002- 07 Amendment.pdf PDF
Attachment 3 - CCN Next Gen - Medical East TOPR Price Schedule v3.xlsx XLSX spreadsheet
CCN Next Gen - Medical TOPR East 0001- 07 Amendment.pdf PDF
CCN NG Medical Record of Questions Amendment 0013.pdf PDF
Attachment 1 - CCN Next Gen - Medical TOPR PWS_West_03_05_26 v3.pdf PDF
36C10G26R0003 0012 CCN Next Gen Medical Amendment.pdf PDF
Attachment Ca - QASP Medical East by CA_02_24_26 v2.pdf PDF
Attachment C - Performance Requirement Summary_Medical West_02_24_26 v3.pdf PDF
Attachment 6 - Disaster Benefit data.pdf PDF
36C10G26R0003 Medical TOPR West 0002 - 05.pdf PDF
Attachment 1 - CCN Next Gen Medical IDIQ PWS_02_25_26_v2.pdf PDF
CCN Next Gen - Eligibility_Enrollment Slides.pdf PDF
CCN Next Gen - Referrals_Authorizations_SEOCs Overview.mp4 MP4 file
CCN Next Gen - Care Coordintion Overview.mp4 MP4 file
CCN Next Gen Medical TOPR East 0001-04 Amendment.pdf PDF
CCN Next Gen Medical West TOPR 0002-03 Amendment.pdf PDF
Medical TOPR West 0002 02 Amendment.pdf PDF
CCN Next Gen Medical Pre-Proposal Conference 01212026 Slides.pdf PDF
CCN Next Gen Medical Pre-proposal Conference recording 01212026.mp4 MP4 file
Attachment T Incentive Disincentive Plan West.pdf PDF
Medical TOPR West 0002-01 Amendment.pdf PDF
36C10G26R0003 0004 CCN Next Gen Medical Amendment.pdf PDF
36C10G26R0003 0001 CCN Next Gen Medical RFP Amendment 12.23.25.pdf PDF
Attachment B Project Risk Register.xlsx XLSX spreadsheet
Attachment Ca- QASP Medical East by CA.docx DOCX document
Attachment G Medical Network Waiver Request Form.pdf PDF
Attachment J Eligibility Verification and Enrollment Data Exchange.docx DOCX document
Attachment If Post-Adjudication 835 Community Care Network Companion Guide.pdf PDF
Attachment M Interconnection Security Agreement.docx DOCX document
Attachment 3 CCN Next Generation Medical East Price Schedule.xlsx XLSX spreadsheet
Attachment 3 CCN Next Generation Medical West Price Schedule.xlsx XLSX spreadsheet
Attachment 1 - CCN Next Gen - Medical East TOPR PWS.pdf PDF
Attachment 1 - CCN Next Gen - Medical West TOPR PWS.pdf PDF
Next Gen Medical TOPR East vFINAL 12.14.25_JP.pdf PDF
Attachment 1-CCN Next Gen Medical IDIQ PWS.docx DOCX document
Next Gen Medical Combined synopsis_solicitation_Final_12152025.docx DOCX document
Show 40 more

50 files listed here. See the rest on GovTribe.

On GovTribe

Work with this file

  • Download the original file
  • Contacts named in this file
  • Similar government files
  • Ask GovTribe AI about this file

Text version

Final List for IEN 1.27 Service Categories Type Code Description TPA Clinical Review Y/N

Ambulatory/SurgicalCPT10005Fine needle aspiration biopsy, including ultrasound guidance; first lesionN
Ambulatory/SurgicalCPT10007Fine needle aspiration biopsy, including fluoroscopic guidance; first lesionN
Ambulatory/SurgicalCPT10009Fine needle aspiration biopsy, including CT guidance; first lesionN
Ambulatory/SurgicalCPT10011Fine needle aspiration biopsy, including MR guidance; first lesionN
Ambulatory/SurgicalCPT10021Fine needle aspiration biopsy, without imaging guidance; first lesionN
Ambulatory/SurgicalCPT11102Tangential biopsy of skin (eg, shave, scoop, saucerize, curette); single lesionN
Ambulatory/SurgicalCPT11104Punch biopsy of skin (including simple closure, when performed); single lesionN
Ambulatory/SurgicalCPT11106Incisional biopsy of skin (eg, wedge) (including simple closure, when performed); single lesionN
Ambulatory/SurgicalCPT11950Subcutaneous injection of filling material (eg, collagen); 1 cc or lessN
Ambulatory/SurgicalCPT11951Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 ccN
Ambulatory/SurgicalCPT11952Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 ccN
Ambulatory/SurgicalCPT11954Subcutaneous injection of filling material (eg, collagen); over 10.0 ccN
Ambulatory/SurgicalCPT11960Insertion of tissue expander(s) for other than breast, including subsequent expansionN
Ambulatory/SurgicalCPT11970Replacement of tissue expander with permanent implantN
Ambulatory/SurgicalCPT11971Removal of tissue expander without insertion of implantN
Ambulatory/SurgicalCPT13101Repair, complex, trunk; 2.6 cm to 7.5 cmN
Ambulatory/SurgicalCPT13132Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cmN
Ambulatory/SurgicalCPT14000Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or lessN
Ambulatory/SurgicalCPT14001Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cmN
Ambulatory/SurgicalCPT14020Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or lessN
Ambulatory/SurgicalCPT14021Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cmN
Ambulatory/SurgicalCPT14040Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or lessN
Ambulatory/SurgicalCPT14041Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cmN
Ambulatory/SurgicalCPT14060Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or lessN
Ambulatory/SurgicalCPT14061Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cmN
Ambulatory/SurgicalCPT14301Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cmN
Ambulatory/SurgicalCPT15570Formation of direct or tubed pedicle, with or without transfer; trunkN
Ambulatory/SurgicalCPT15572Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legsN
Ambulatory/SurgicalCPT15574Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feetN
Ambulatory/SurgicalCPT15730Midface flap (ie, zygomaticofacial flap) with preservation of vascular pedicle(s)N
Ambulatory/SurgicalCPT15733Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sterNocleidomastoid, levator scapulae)N
Ambulatory/SurgicalCPT15734Muscle, myocutaneous, or fasciocutaneous flap; trunkN
Ambulatory/SurgicalCPT15738Muscle, myocutaneous, or fasciocutaneous flap; lower extremityN
Ambulatory/SurgicalCPT15740Flap; island pedicle requiring identification and dissection of an anatomically named axial vesselN
Ambulatory/SurgicalCPT15750Flap; neurovascular pedicleN
Ambulatory/SurgicalCPT15756Free muscle or myocutaneous flap with microvascular anastomosisN
Ambulatory/SurgicalCPT15757Free skin flap with microvascular anastomosisN
Ambulatory/SurgicalCPT15758Free fascial flap with microvascular anastomosisN
Ambulatory/SurgicalCPT15769Grafting of autologous soft tissue, other, harvested by direct excision (eg, fat, dermis, fascia)N
Ambulatory/SurgicalCPT15771Grafting of autologous fat harvested by liposuction technique to trunk, breasts, scalp, arms, and/or legs; 50 cc or less injectateN
Ambulatory/SurgicalCPT15773Grafting of autologous fat harvested by liposuction technique to face, eyelids, mouth, neck, ears, orbits, genitalia, hands, and/or feet; 25 cc or less injectateN
Ambulatory/SurgicalCPT15820Blepharoplasty, lower eyelid;N
Ambulatory/SurgicalCPT15821Blepharoplasty, lower eyelid; with extensive herniated fat padN
Ambulatory/SurgicalCPT15822Blepharoplasty, upper eyelid;N
Ambulatory/SurgicalCPT15823Blepharoplasty, upper eyelid; with excessive skin weighting down lidN
Ambulatory/SurgicalCPT15830Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomyN
Ambulatory/SurgicalCPT17106Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cmN
Ambulatory/SurgicalCPT17107Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cmN
Ambulatory/SurgicalCPT17108Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cmN
Ambulatory/SurgicalCPT17999Unlisted procedure, skin, mucous membrane and subcutaneous tissueN
Ambulatory/SurgicalCPT19000Puncture aspiration of cyst of breast;N
Ambulatory/SurgicalCPT19300Mastectomy for gynecomastiaN
Ambulatory/SurgicalCPT19303Mastectomy, simple, completeN
Ambulatory/SurgicalCPT19316MastopexyN
Ambulatory/SurgicalCPT19318Breast ReductionN
Ambulatory/SurgicalCPT19328Removal of intact breast implantN
Ambulatory/SurgicalCPT19330Removal of ruptured breast implant, including implant contents (eg, saline, silicone gel)N
Ambulatory/SurgicalCPT19340Insertion of breast implant on same day of mastectomy (ie, immediate)N
Ambulatory/SurgicalCPT19342Insertion or replacement of breast implant on separate day from mastectomyN
Ambulatory/SurgicalCPT19350Nipple/areola reconstructionN
Ambulatory/SurgicalCPT19357Tissue expander placement in breast reconstruction, including subsequent expansion(s)N
Ambulatory/SurgicalCPT19361Breast reconstruction; with latissimus dorsi flapN
Ambulatory/SurgicalCPT19364Breast reconstruction; with free flap (eg, fTRAM, DIEP, SIEA, GAP flap)N
Ambulatory/SurgicalCPT19367Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flapN
Ambulatory/SurgicalCPT19368Breast reconstruction; with single-pedicled transverse rectus abdominis myocutaneous (TRAM) flap, requiring separate microvascular anastomosis (supercharging)N
Ambulatory/SurgicalCPT19369Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flapN
Ambulatory/SurgicalCPT19370Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomyN
Ambulatory/SurgicalCPT19371Peri-implant capsulectomy, breast, complete, including removal of all intracapsular contentsN
Ambulatory/SurgicalCPT19396Preparation of moulage for custom breast implantN
Ambulatory/SurgicalCPT20552Injection(s); single or multiple trigger point(s), 1 or 2 muscle(s)N
Ambulatory/SurgicalCPT20553Injection(s); single or multiple trigger point(s), 3 or more musclesN
Ambulatory/SurgicalCPT20600Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidanceN
Ambulatory/SurgicalCPT20604Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, fingers, toes); with ultrasound guidance, with permanent recording and reportingN
Ambulatory/SurgicalCPT20605Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidanceN
Ambulatory/SurgicalCPT20606Arthrocentesis, aspiration and/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reportingN
Ambulatory/SurgicalCPT20610Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); without ultrasound guidanceN
Ambulatory/SurgicalCPT20611Arthrocentesis, aspiration and/or injection, major joint or bursa (eg, shoulder, hip, knee, subacromial bursa); with ultrasound guidance, with permanent recording and reportingN
Ambulatory/SurgicalCPT20680Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)Y
Ambulatory/SurgicalCPT20974Electrical stimulation to aid bone healing; noninvasive (nonoperative)Y
Ambulatory/SurgicalCPT20975Electrical stimulation to aid bone healing; invasive (operative)Y
Ambulatory/SurgicalCPT20979Low intensity ultrasound stimulation to aid bone healing, noninvasive (nonoperative)Y
Ambulatory/SurgicalCPT21050Condylectomy, temporomandibular joint (separate procedure)Y
Ambulatory/SurgicalCPT21060Meniscectomy, partial or complete, temporomandibular joint (separate procedure)Y
Ambulatory/SurgicalCPT21070Coronoidectomy (separate procedure)Y
Ambulatory/SurgicalCPT21073Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)N
Ambulatory/SurgicalCPT21120Genioplasty; augmentation (autograft, allograft, prosthetic material)N
Ambulatory/SurgicalCPT21121Genioplasty; sliding osteotomy, single pieceN
Ambulatory/SurgicalCPT21122Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)N
Ambulatory/SurgicalCPT21123Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21125Augmentation, mandibular body or angle; prosthetic materialN
Ambulatory/SurgicalCPT21127Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)N
Ambulatory/SurgicalCPT21137Reduction forehead; contouring onlyN
Ambulatory/SurgicalCPT21138Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)N
Ambulatory/SurgicalCPT21139Reduction forehead; contouring and setback of anterior frontal sinus wallN
Ambulatory/SurgicalCPT21141Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graftN
Ambulatory/SurgicalCPT21142Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graftN
Ambulatory/SurgicalCPT21143Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graftN
Ambulatory/SurgicalCPT21145Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21146Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)N
Ambulatory/SurgicalCPT21147Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)N
Ambulatory/SurgicalCPT21150Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)N
Ambulatory/SurgicalCPT21151Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21154Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort IN
Ambulatory/SurgicalCPT21155Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort IN
Ambulatory/SurgicalCPT21159Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort IN
Ambulatory/SurgicalCPT21160Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort IN
Ambulatory/SurgicalCPT21172Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21175Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21179Reconstruction, entire or majority of forehead and/or supraorbital rims; with grafts (allograft or prosthetic material)N
Ambulatory/SurgicalCPT21180Reconstruction, entire or majority of forehead and/or supraorbital rims; with autograft (includes obtaining grafts)N
Ambulatory/SurgicalCPT21181Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranialN
Ambulatory/SurgicalCPT21182Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cmN
Ambulatory/SurgicalCPT21183Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 40 sq cm but less than 80 sq cmN
Ambulatory/SurgicalCPT21184Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone (eg, fibrous dysplasia), with multiple autografts (includes obtaining grafts); total area of bone grafting greater than 80 sq cmN
Ambulatory/SurgicalCPT21188Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)N
Ambulatory/SurgicalCPT21193Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graftN
Ambulatory/SurgicalCPT21194Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)N
Ambulatory/SurgicalCPT21195Reconstruction of mandibular rami and/or body, sagittal split; without internal rigid fixationN
Ambulatory/SurgicalCPT21196Reconstruction of mandibular rami and/or body, sagittal split; with internal rigid fixationN
Ambulatory/SurgicalCPT21198Osteotomy, mandible, segmental;N
Ambulatory/SurgicalCPT21199Osteotomy, mandible, segmental; with genioglossus advancementN
Ambulatory/SurgicalCPT21206Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)N
Ambulatory/SurgicalCPT21208Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)N
Ambulatory/SurgicalCPT21209Osteoplasty, facial bones; reductionN
Ambulatory/SurgicalCPT21210Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)N
Ambulatory/SurgicalCPT21215Graft, bone; mandible (includes obtaining graft)N
Ambulatory/SurgicalCPT21230Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)N
Ambulatory/SurgicalCPT21235Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)N
Ambulatory/SurgicalCPT21240Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)N
Ambulatory/SurgicalCPT21242Arthroplasty, temporomandibular joint, with allograftN
Ambulatory/SurgicalCPT21243Arthroplasty, temporomandibular joint, with prosthetic joint replacementN
Ambulatory/SurgicalCPT21244Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)N
Ambulatory/SurgicalCPT21245Reconstruction of mandible or maxilla, subperiosteal implant; partialN
Ambulatory/SurgicalCPT21246Reconstruction of mandible or maxilla, subperiosteal implant; completeN
Ambulatory/SurgicalCPT21247Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)N
Ambulatory/SurgicalCPT21248Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partialN
Ambulatory/SurgicalCPT21249Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); completeN
Ambulatory/SurgicalCPT21255Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)N
Ambulatory/SurgicalCPT21256Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)N
Ambulatory/SurgicalCPT21260Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approachN
Ambulatory/SurgicalCPT21261Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approachN
Ambulatory/SurgicalCPT21263Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancementN
Ambulatory/SurgicalCPT21267Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approachN
Ambulatory/SurgicalCPT21268Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approachN
Ambulatory/SurgicalCPT21270Malar augmentation, prosthetic materialN
Ambulatory/SurgicalCPT21275Secondary revision of orbitocraniofacial reconstructionN
Ambulatory/SurgicalCPT21280Medial canthopexy (separate procedure)N
Ambulatory/SurgicalCPT21282Lateral canthopexyN
Ambulatory/SurgicalCPT21295Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approachN
Ambulatory/SurgicalCPT21296Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approachN
Ambulatory/SurgicalCPT21299Unlisted craniofacial and maxillofacial procedureN
Ambulatory/SurgicalCPT21320Closed treatment of nasal bone fracture with manipulation; with stabilizationN
Ambulatory/SurgicalCPT21480Closed treatment of temporomandibular dislocation; initial or subsequentN
Ambulatory/SurgicalCPT21485Closed treatment of temporomandibular dislocation; complicated (eg, relegacy requiring intermaxillary fixation or splinting), initial or subsequentN
Ambulatory/SurgicalCPT21490Open treatment of temporomandibular dislocationN
Ambulatory/SurgicalCPT21550Biopsy, soft tissue of neck or thoraxN
Ambulatory/SurgicalCPT21552Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greaterN
Ambulatory/SurgicalCPT21555Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cmN
Ambulatory/SurgicalCPT21556Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cmN
Ambulatory/SurgicalCPT21557Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cmN
Ambulatory/SurgicalCPT21558Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greaterN
Ambulatory/SurgicalCPT21685Hyoid myotomy and suspensionN
Ambulatory/SurgicalCPT21740Reconstructive repair of pectus excavatum or carinatum; openN
Ambulatory/SurgicalCPT21742Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), without thoracoscopyN
Ambulatory/SurgicalCPT21743Reconstructive repair of pectus excavatum or carinatum; minimally invasive approach (Nuss procedure), with thoracoscopyN
Ambulatory/SurgicalCPT21931Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greaterN
Ambulatory/SurgicalCPT22100Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; cervicalY
Ambulatory/SurgicalCPT22101Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; thoracicY
Ambulatory/SurgicalCPT22102Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; lumbarY
Ambulatory/SurgicalCPT22110Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; cervicalY
Ambulatory/SurgicalCPT22112Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; thoracicY
Ambulatory/SurgicalCPT22114Partial excision of vertebral body, for intrinsic bony lesion, without decompression of spinal cord or nerve root(s), single vertebral segment; lumbarY
Ambulatory/SurgicalCPT22206Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); thoracicY
Ambulatory/SurgicalCPT22207Osteotomy of spine, posterior or posterolateral approach, 3 columns, 1 vertebral segment (eg, pedicle/vertebral body subtraction); lumbarY
Ambulatory/SurgicalCPT22210Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; cervicalY
Ambulatory/SurgicalCPT22212Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; thoracicY
Ambulatory/SurgicalCPT22214Osteotomy of spine, posterior or posterolateral approach, 1 vertebral segment; lumbarY
Ambulatory/SurgicalCPT22220Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; cervicalY
Ambulatory/SurgicalCPT22222Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; thoracicY
Ambulatory/SurgicalCPT22224Osteotomy of spine, including discectomy, anterior approach, single vertebral segment; lumbarY
Ambulatory/SurgicalCPT22310Closed treatment of vertebral body fracture(s), without manipulation, requiring and including casting or bracingY
Ambulatory/SurgicalCPT22315Closed treatment of vertebral fracture(s) and/or dislocation(s) requiring casting or bracing, with and including casting and/or bracing by manipulation or tractionY
Ambulatory/SurgicalCPT22318Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; without graftingY
Ambulatory/SurgicalCPT22319Open treatment and/or reduction of odontoid fracture(s) and or dislocation(s) (including os odontoideum), anterior approach, including placement of internal fixation; with graftingY
Ambulatory/SurgicalCPT22325Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; lumbarY
Ambulatory/SurgicalCPT22326Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; cervicalY
Ambulatory/SurgicalCPT22327Open treatment and/or reduction of vertebral fracture(s) and/or dislocation(s), posterior approach, 1 fractured vertebra or dislocated segment; thoracicY
Ambulatory/SurgicalCPT22510Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; cervicothoracicY
Ambulatory/SurgicalCPT22511Percutaneous vertebroplasty (bone biopsy included when performed), 1 vertebral body, unilateral or bilateral injection, inclusive of all imaging guidance; lumbosacralY
Ambulatory/SurgicalCPT22513Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; thoracicY
Ambulatory/SurgicalCPT22514Percutaneous vertebral augmentation, including cavity creation (fracture reduction and bone biopsy included when performed) using mechanical device (eg, kyphoplasty), 1 vertebral body, unilateral or bilateral cannulation, inclusive of all imaging guidance; lumbarY
Ambulatory/SurgicalCPT22532Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); thoracicY
Ambulatory/SurgicalCPT22533Arthrodesis, lateral extracavitary technique, including minimal discectomy to prepare interspace (other than for decompression); lumbarY
Ambulatory/SurgicalCPT22548Arthrodesis, anterior transoral or extraoral technique, clivus-C1-C2 (atlas-axis), with or without excision of odontoid processY
Ambulatory/SurgicalCPT22551Arthrodesis, anterior interbody, including disc space preparation, discectomy, osteophytectomy and decompression of spinal cord and/or nerve roots; cervical below C2Y
Ambulatory/SurgicalCPT22554Arthrodesis, anterior interbody technique; including minimal discectomy to prepare interspace (other than for decompression); cervical below c2Y
Ambulatory/SurgicalCPT22556Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); thoracicY
Ambulatory/SurgicalCPT22558Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace (other than for decompression); lumbarY
Ambulatory/SurgicalCPT22586Arthrodesis, pre-sacral interbody technique, including disc space preparation, discectomy, with posterior instrumentation, with image guidance, includes bone graft when performed, L5-S1 interspaceY
Ambulatory/SurgicalCPT22590Arthrodesis, posterior technique, craniocervical (occiput-C2)Y
Ambulatory/SurgicalCPT22595Arthrodesis, posterior technique, atlas-axis (C1-C2)Y
Ambulatory/SurgicalCPT22600Arthrodesis, posterior or posterolateral technique, single interspace; cervical below C2 segmentY
Ambulatory/SurgicalCPT22610Arthrodesis, posterior or posterolateral technique, single interspace; thoracic (with lateral transverse technique, when performed)Y
Ambulatory/SurgicalCPT22612Arthrodesis, posterior or posterolateral technique, single interspace; lumbar (with lateral transverse technique, when performed)Y
Ambulatory/SurgicalCPT22630Arthrodesis, posterior interbody technique, including laminectomy and/or discectomy to prepare interspace (other than for decompression), single interspace, lumbar;Y
Ambulatory/SurgicalCPT22633Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;Y
Ambulatory/SurgicalCPT22800Arthrodesis, posterior, for spinal deformity, with or without cast; up to 6 vertebral segmentsY
Ambulatory/SurgicalCPT22802Arthrodesis, posterior, for spinal deformity, with or without cast; 7 to 12 vertebral segmentsY
Ambulatory/SurgicalCPT22804Arthrodesis, posterior, for spinal deformity, with or without cast; 13 or more vertebral segmentsY
Ambulatory/SurgicalCPT22808Arthrodesis, anterior, for spinal deformity, with or without cast; 2 to 3 vertebral segmentsY
Ambulatory/SurgicalCPT22810Arthrodesis, posterior, for spinal deformity, with or without cast; 4 to 7 vertebral segmentsY
Ambulatory/SurgicalCPT22812Arthrodesis, posterior, for spinal deformity, with or without cast; 8 or more vertebral segmentsY
Ambulatory/SurgicalCPT22818Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); single or 2 segmentsY
Ambulatory/SurgicalCPT22819Kyphectomy, circumferential exposure of spine and resection of vertebral segment(s) (including body and posterior elements); 3 or more segmentsY
Ambulatory/SurgicalCPT22830Exploration of spinal fusionY
Ambulatory/SurgicalCPT22849Reinsertion of spinal fixation deviceY
Ambulatory/SurgicalCPT22850Removal of posterior nonsegmental instrumentation (eg, Harrington rod)Y
Ambulatory/SurgicalCPT22852Removal of posterior segmental instrumentationY
Ambulatory/SurgicalCPT22855Removal of anterior instrumentationY
Ambulatory/SurgicalCPT22856Total disc arthroplasty (artificial disc), anterior approach, including discectomy with end plate preparation (includes osteophytectomy for nerve root or spinal cord decompression and microdissection); single interspace, cervicalY
Ambulatory/SurgicalCPT22857Total disc arthroplasty (artificial disc), anterior approach, including discectomy to prepare interspace (other than for decompression), single interspace, lumbarY
Ambulatory/SurgicalCPT22861Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; cervicalY
Ambulatory/SurgicalCPT22862Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbarY
Ambulatory/SurgicalCPT22865Removal of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbarY
Ambulatory/SurgicalCPT22899Unlisted procedure, spineY
Ambulatory/SurgicalCPT23430Tendonesis of long tendon of bicepsY
Ambulatory/SurgicalCPT23470Arthroplasty, glenohumeral joint; hemiarthroplastyY
Ambulatory/SurgicalCPT23472Arthroplasty, glenohumeral joint; total shoulder (glenoid and proximal humeral replacement (eg, total shoulder))Y
Ambulatory/SurgicalCPT23473Revision of total shoulder arthroplasty, including allograft when performed; humeral or glenoid componentY
Ambulatory/SurgicalCPT23474Revision of total shoulder arthroplasty, including allograft when performed; humeral and glenoid componentY
Ambulatory/SurgicalCPT24360Arthroplasty, elbow; with membrane (eg, fascial)Y
Ambulatory/SurgicalCPT24361Arthroplasty, elbow; with distal humeral prosthetic replacementY
Ambulatory/SurgicalCPT24362Arthroplasty, elbow; with implant and fascia lata ligament reconstructionY
Ambulatory/SurgicalCPT24363Arthroplasty, elbow; with distal humerus and proximal ulnar prosthetic replacement (eg, total elbow)Y
Ambulatory/SurgicalCPT24365Arthroplasty, radial head;Y
Ambulatory/SurgicalCPT24366Arthroplasty, radial head; with implantY
Ambulatory/SurgicalCPT24370Revision of total elbow arthroplasty, including allograft when performed; humeral or ulnar componentY
Ambulatory/SurgicalCPT24371Revision of total elbow arthroplasty, including allograft when performed; humeral and ulnar componentY
Ambulatory/SurgicalCPT25111Excision of ganglion, wrist (dorsal or volar); primaryY
Ambulatory/SurgicalCPT25310Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; each tendonY
Ambulatory/SurgicalCPT25312Tendon transplantation or transfer, flexor or extensor, forearm and/or wrist, single; with tendon graft(s) (includes obtaining graft), each tendonY
Ambulatory/SurgicalCPT25441Arthroplasty with prosthetic replacement; distal radiusY
Ambulatory/SurgicalCPT25442Arthroplasty with prosthetic replacement; distal ulnaY
Ambulatory/SurgicalCPT25443Arthroplasty with prosthetic replacement; scaphoid carpal (navicular)Y
Ambulatory/SurgicalCPT25444Arthroplasty with prosthetic replacement; lunateY
Ambulatory/SurgicalCPT25446Arthroplasty with prosthetic replacement; distal radius and partial or entire carpus (total wrist)Y
Ambulatory/SurgicalCPT25449Revision of arthroplasty, including removal of implant, wrist jointY
Ambulatory/SurgicalCPT25609Open treatment of distal radial intra-articular fracture or epiphyseal separation; with internal fixation of 3 or more fragmentsY
Ambulatory/SurgicalCPT26055Tendon sheath incision (eg, for trigger finger)Y
Ambulatory/SurgicalCPT26160Excision of lesion of tendon sheath or joint capsule (eg, cyst, mucous cyst, or ganglion), hand or fingerY
Ambulatory/SurgicalCPT26340Manipulation, finger joint, under anesthesia, each jointY
Ambulatory/SurgicalCPT26480Transfer or transplant of tendon, carpometacarpal area or dorsum of hand; without free graft, each tendonY
Ambulatory/SurgicalCPT26530Arthroplasty, metacarpophalangeal joint; each jointY
Ambulatory/SurgicalCPT26535Arthroplasty, interphalangeal joint; each jointY
Ambulatory/SurgicalCPT26989Unlisted procedure, hands or fingersY
Ambulatory/SurgicalCPT27090Removal of hip prosthesis; (separate procedure)Y
Ambulatory/SurgicalCPT27091Removal of hip prosthesis; complicated, including total hip prosthesis, methylmethacrylate with or without insertion of spacerY
Imaging: CT, PET, MRI, Nuclear MedicineCPT27096Injection procedure for sacroiliac joint, anesthetic/steroid, with image guidance (fluoroscopy or CT) including arthrography when performedY
Ambulatory/SurgicalCPT27120Acetabuloplasty; (eg, Whitman, Colonna, Haygroves, or cup type)Y
Ambulatory/SurgicalCPT27125Hemiarthroplasty, hip, partial (eg, femoral stem prosthesis, bipolar arthroplasty)Y
Ambulatory/SurgicalCPT27130Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograftY
Ambulatory/SurgicalCPT27132Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograftY
Ambulatory/SurgicalCPT27134Revision of total hip arthroplasty; both components, with or without autograft or allograftY
Ambulatory/SurgicalCPT27137Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograftY
Ambulatory/SurgicalCPT27138Revision of total hip arthroplasty; femoral component only, with or without allograftY
Ambulatory/SurgicalCPT27279Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing deviceY
Ambulatory/SurgicalCPT27280Arthrodesis, sacroiliac joint, open, includes obtaining bone graft, including instrumentation, when performedY
Ambulatory/SurgicalCPT27403Arthrotomy with meniscus repair, kneeY
Ambulatory/SurgicalCPT27412Autologous chondrocyte implantation, kneeY
Ambulatory/SurgicalCPT27415Osteochondral allograft, knee, openY
Ambulatory/SurgicalCPT27416Osteochondral autograft(s), knee, open (eg, mosaicplasty) (includes harvesting of autograft[s])Y
Ambulatory/SurgicalCPT27437Arthroplasty, patella; without prosthesisY
Ambulatory/SurgicalCPT27438Arthroplasty, patella; with prosthesisY
Ambulatory/SurgicalCPT27440Arthroplasty, knee, tibial plateau;Y
Ambulatory/SurgicalCPT27441Arthroplasty, knee, tibial plateau; with debridement and partial synovectomyY
Ambulatory/SurgicalCPT27442Arthroplasty, femoral condyles or tibial plateau(s), knee;Y
Ambulatory/SurgicalCPT27443Arthroplasty, femoral condyles or tibial plateau(s), knee; with debridement and partial synovectomyY
Ambulatory/SurgicalCPT27445Arthroplasty, knee, hinge prosthesis (eg, Walldius type)Y
Ambulatory/SurgicalCPT27446Arthroplasty, knee, condyle and plateau; medial OR lateral compartmentY
Ambulatory/SurgicalCPT27447Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)Y
Ambulatory/SurgicalCPT27486Revision of total knee arthroplasty, with or without allograft; 1 componentY
Ambulatory/SurgicalCPT27487Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial componentY
Ambulatory/SurgicalCPT27488Removal of prosthesis, including total knee prosthesis, methylmethacrylate with or without insertion of spacer, kneeY
Ambulatory/SurgicalCPT27570Manipulation of knee joint under general anesthesia (includes application of traction or other fixation devices)Y
Ambulatory/SurgicalCPT27650Repair, primary, open or percutaneous, ruptured Achilles tendon;Y
Ambulatory/SurgicalCPT27690Transfer or transplant of single tendon (with muscle redirection or rerouting); superficial (eg, anterior tibial extensors into midfoot)Y
Ambulatory/SurgicalCPT27698Repair, secondary, disrupted ligament, ankle, collateral (eg, Watson-Jones procedure)Y
Ambulatory/SurgicalCPT27700Arthroplasty, ankle;Y
Ambulatory/SurgicalCPT27702Arthroplasty, ankle; with implant (total ankle)Y
Ambulatory/SurgicalCPT27703Arthroplasty, ankle; revision, total ankleY
Ambulatory/SurgicalCPT28060Fasciectomy, plantar fascia; partial (separate procedure)Y
Ambulatory/SurgicalCPT28080Excision, interdigital (Morton) neuroma, single, eachY
Ambulatory/SurgicalCPT28285Correction, hammertoe (eg, interphalangeal fusion, partial or total phalangectomy)Y
Ambulatory/SurgicalCPT28289Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; without implantY
Ambulatory/SurgicalCPT28291Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint ; with implantY
Ambulatory/SurgicalCPT28292Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with resection of proximal phalanx base, when performed, any methodY
Ambulatory/SurgicalCPT28296Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with distal metatarsal osteotomy, any methoY
Ambulatory/SurgicalCPT28297Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with first metatarsal and medial cuneiform joint arthrodesis, any methodY
Ambulatory/SurgicalCPT28298Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with proximal phalanx osteotomy, any methodY
Ambulatory/SurgicalCPT28299Correction, hallux valgus with bunionectomy, with sesamoidectomy when performed; with double osteotomy, any methodY
Ambulatory/SurgicalCPT29800Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29804Arthroscopy, temporomandibular joint, surgicalY
Ambulatory/SurgicalCPT29805Arthroscopy, shoulder, diagnostic, with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29806Arthroscopy, shoulder, surgical; capsulorrhaphyY
Ambulatory/SurgicalCPT29807Arthroscopy, shoulder, surgical; repair of SLAP lesionY
Ambulatory/SurgicalCPT29819Arthroscopy, shoulder, surgical; with removal of loose body or foreign bodyY
Ambulatory/SurgicalCPT29820Arthroscopy, shoulder, surgical; synovectomy, partialY
Ambulatory/SurgicalCPT29821Arthroscopy, shoulder, surgical; synovectomy, completeY
Ambulatory/SurgicalCPT29822Arthroscopy, shoulder, surgical; debridement, limited, 1 or 2 discrete structures (eg, 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])Y
Ambulatory/SurgicalCPT29823Arthroscopy, shoulder, surgical; debridement, extensive, 3 or more discrete structures (eg, 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])Y
Ambulatory/SurgicalCPT29824Arthroscopy, shoulder, surgical; distal claviculectomy including distal articular surface (Mumford procedure)Y
Ambulatory/SurgicalCPT29825Arthroscopy, shoulder, surgical; with lysis and resection of adhesions, with or without manipulationY
Ambulatory/SurgicalCPT29827Arthroscopy, shoulder, surgical; with rotator cuff repairY
Ambulatory/SurgicalCPT29828Arthroscopy, shoulder, surgical; biceps tenodesisY
Ambulatory/SurgicalCPT29830Arthroscopy, elbow, diagnostic, with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29834Arthroscopy, elbow, surgical; with removal of loose body or foreign bodyY
Ambulatory/SurgicalCPT29835Arthroscopy, elbow, surgical; synovectomy, partialY
Ambulatory/SurgicalCPT29836Arthroscopy, elbow, surgical; synovectomy, completeY
Ambulatory/SurgicalCPT29837Arthroscopy, elbow, surgical; debridement, limitedY
Ambulatory/SurgicalCPT29838Arthroscopy, elbow, surgical; debridement, extensiveY
Ambulatory/SurgicalCPT29840Arthroscopy, wrist, diagnostic, with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29843Arthroscopy, wrist, surgical; for infection, lavage and drainageY
Ambulatory/SurgicalCPT29844Arthroscopy, wrist, surgical; synovectomy, partialY
Ambulatory/SurgicalCPT29845Arthroscopy, wrist, surgical; synovectomy, completeY
Ambulatory/SurgicalCPT29847Arthroscopy, wrist, surgical; internal fixation for fracture or instabilityY
Ambulatory/SurgicalCPT29848Endoscopy, wrist, surgical, with release of transverse carpal ligamentY
Ambulatory/SurgicalCPT29860Arthroscopy, hip, diagnostic with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29861Arthroscopy, hip, surgical; with removal of loose body or foreign bodyY
Ambulatory/SurgicalCPT29862Arthroscopy, hip, surgical; with debridement/shaving of articular cartilage (chondroplasty), abrasion arthroplasty, and/or resection of labrumY
Ambulatory/SurgicalCPT29863Arthroscopy, hip, surgical; with synovectomyY
Ambulatory/SurgicalCPT29866Arthroscopy, knee, surgical; osteochondral autograft(s) (eg, mosaicplasty) (includes harvesting of the autograft[s])Y
Ambulatory/SurgicalCPT29867Arthroscopy, knee, surgical; osteochondral allograft (eg, mosaicplasty)Y
Ambulatory/SurgicalCPT29868Arthroscopy, knee, surgical; meniscal transplantation (includes arthrotomy for meniscal insertion), medial or lateralY
Ambulatory/SurgicalCPT29870Arthroscopy, knee, diagnostic, with or without synovial biopsy (separate procedure)Y
Ambulatory/SurgicalCPT29871Arthroscopy, knee, surgical; for infection, lavage and drainageY
Ambulatory/SurgicalCPT29873Arthroscopy, knee, surgical; with lateral releaseY
Ambulatory/SurgicalCPT29874Arthroscopy, knee, surgical; for removal of loose body or foreign body (eg, osteochondritis dissecans fragmentation, chondral fragmentation)Y
Ambulatory/SurgicalCPT29875Arthroscopy, knee, surgical; synovectomy, limited (eg, plica or shelf resection) (separate procedure)Y
Ambulatory/SurgicalCPT29876Arthroscopy, knee, surgical; synovectomy, major, 2 or more compartments (eg, medial or lateral)Y
Ambulatory/SurgicalCPT29877Arthroscopy, knee, surgical; debridement/shaving of articular cartilage (chondroplasty)Y
Ambulatory/SurgicalCPT29879Arthroscopy, knee, surgical; abrasion arthroplasty (includes chondroplasty where necessary) or multiple drilling or microfractureY
Ambulatory/SurgicalCPT29880Arthroscopy, knee, surgical; with meniscectomy (medial AND lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performedY
Ambulatory/SurgicalCPT29881Arthroscopy, knee, surgical; with meniscectomy (medial OR lateral, including any meniscal shaving) including debridement/shaving of articular cartilage (chondroplasty), same or separate compartment(s), when performedY
Ambulatory/SurgicalCPT29882Arthroscopy, knee, surgical; with meniscus repair (medial OR lateral)Y
Ambulatory/SurgicalCPT29883Arthroscopy, knee, surgical; with meniscus repair (medial AND lateral)Y
Ambulatory/SurgicalCPT29884Arthroscopy, knee, surgical; with lysis of adhesions, with or without manipulation (separate procedure)Y
Ambulatory/SurgicalCPT29885Arthroscopy, knee, surgical; drilling for osteochondritis dissecans with bone grafting, with or without internal fixation (including debridement of base of lesion)Y
Ambulatory/SurgicalCPT29886Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesionY
Ambulatory/SurgicalCPT29887Arthroscopy, knee, surgical; drilling for intact osteochondritis dissecans lesion with internal fixationY
Ambulatory/SurgicalCPT29888Arthroscopically aided anterior cruciate ligament repair/augmentation or reconstructionY
Ambulatory/SurgicalCPT29889Arthroscopically aided posterior cruciate ligament repair/augmentation or reconstructionY
Ambulatory/SurgicalCPT29891Arthroscopy, ankle, surgical, excision of osteochondral defect of talus and/or tibia, including drilling of the defectY
Ambulatory/SurgicalCPT29892Arthroscopically aided repair of large osteochondritis dissecans lesion, talar dome fracture, or tibial plafond fracture, with or without internal fixation (includes arthroscopy)Y
Ambulatory/SurgicalCPT29893Endoscopic plantar fasciotomyY
Ambulatory/SurgicalCPT29894Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with removal of loose body or foreign bodyY
Ambulatory/SurgicalCPT29895Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; synovectomy, partialY
Ambulatory/SurgicalCPT29897Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, limitedY
Ambulatory/SurgicalCPT29898Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; debridement, extensiveY
Ambulatory/SurgicalCPT29899Arthroscopy, ankle (tibiotalar and fibulotalar joints), surgical; with ankle arthrodesisY
Ambulatory/SurgicalCPT29901Arthroscopy, metacarpophalangeal joint, surgical; with debridementY
Ambulatory/SurgicalCPT29902Arthroscopy, metacarpophalangeal joint, surgical; with reduction of displaced ulnar collateral ligament (eg, Stenar lesion)Y
Ambulatory/SurgicalCPT29914Arthroscopy, hip, surgical; with femoroplasty (i.e., treatment of cam lesion)Y
Ambulatory/SurgicalCPT29915Arthroscopy, hip, surgical; with acetabuloplasty (i.e., treatment of pincer lesion)Y
Ambulatory/SurgicalCPT29916Arthroscopy, hip, surgical; with labral repairY
Ambulatory/SurgicalCPT30140Submucous resection inferior turbinate, partial or complete, any methodN
Ambulatory/SurgicalCPT30400Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tipN
Ambulatory/SurgicalCPT30410Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tipN
Ambulatory/SurgicalCPT30430Rhinoplasty, secondary; minor revision (small amount of nasal tip work)N
Ambulatory/SurgicalCPT30435Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)N
Ambulatory/SurgicalCPT30450Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)N
Ambulatory/SurgicalCPT30462Rhinoplasty for nasal deformity secondary to congenital cleft lip and/or palate, including columellar lengthening; tip, septum, osteotomiesN
Ambulatory/SurgicalCPT30465Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)N
Ambulatory/SurgicalCPT30520Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graftN
Ambulatory/SurgicalCPT30540Repair choanal atresia; intranasalN
Ambulatory/SurgicalCPT30560Lysis intranasal synechiaN
Ambulatory/SurgicalCPT30620Septal or other intranasal dermatoplasty (does not include obtaining graft)N
Ambulatory/SurgicalCPT31253Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including frontal sinus exploration, with removal of tissue from frontal sinus, when performedN
Ambulatory/SurgicalCPT31254Nasal/sinus endoscopy, surgical with ethmoidectomy; partial (anterior)N
Ambulatory/SurgicalCPT31255Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior)N
Ambulatory/SurgicalCPT31256Nasal/sinus endoscopy, surgical, with maxillary antrostomy;N
Ambulatory/SurgicalCPT31257Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomyN
Ambulatory/SurgicalCPT31259Nasal/sinus endoscopy, surgical with ethmoidectomy; total (anterior and posterior), including sphenoidotomy, with removal of tissue from the sphenoid sinusN
Ambulatory/SurgicalCPT31267Nasal/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinusN
Ambulatory/SurgicalCPT31295Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); maxillary sinus ostium, transnasal or via canine fossaN
Ambulatory/SurgicalCPT31296Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); frontal sinus ostiumN
Ambulatory/SurgicalCPT31297Nasal/sinus endoscopy, surgical, with dilation (eg, balloon dilation); sphenoid sinus ostiumN

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated .