Addendum E.-HCPCS Codes That Are Paid Only as Inpatient ...

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201001638 "Anesth, shoulder replacement"01652 "Anesth, shoulder vessel surg"01654 "Anesth, shoulder vessel surg"01656 "Anesth, arm-leg vessel surg"01756 "Anesth, radical humerus surg"01990 Support for organ donor11004 Debride genitalia & perineum11005 Debride abdom wall11006 Debride genit/per/abdom wall11008 Remove mesh from abd wall15756 Free myo/skin flap microvasc15757 "Free skin flap, microvasc"15758 "Free fascial flap, microvasc"16036 Escharotomy; addl incision19271 Revision of chest wall19272 Extensive chest wall surgery19305 "Mast, radical”19306 "Mast, rad, urban type"19361 Breast reconstr w/lat flap19364 Breast reconstruction19367 Breast reconstruction19368 Breast reconstruction19369 Breast reconstruction20661 Application of head brace20664 Halo brace application20802 "Replantation, arm, complete"20805 "Replant forearm, complete"20808 "Replantation hand, complete"20816 "Replantation digit, complete"20824 "Replantation thumb, complete20827 "Replantation thumb, complete20838 "Replantation foot, complete"20930 Sp bone algrft morsel add-on20931 Sp bone algrft struct add-on20936 Sp bone agrft local add-on20937 Sp bone agrft morsel add-on20938 Sp bone agrft struct add-on20955 "Fibula bone graft, microvasc20956 "Iliac bone graft, microvasc20957 "Mt bone graft, microvasc20962 "Other bone graft, microvasc20969 "Bone/skin graft, microvasc20970 "Bone/skin graft, iliac crest21045 Extensive jaw surgery21141 "Reconstruct midface, lefort21142 "Reconstruct midface, lefort21143 "Reconstruct midface, lefort21145 "Reconstruct midface, lefort"21146 "Reconstruct midface, lefort"21147 "Reconstruct midface, lefort"21151 "Reconstruct midface, lefort"21154 "Reconstruct midface, lefort"21155 "Reconstruct midface, lefort"21159 "Reconstruct midface, lefort"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 2

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201021160 "Reconstruct midface, lefort"21179 Reconstruct entire forehead21180 Reconstruct entire forehead21182 Reconstruct cranial bone21183 Reconstruct cranial bone21184 Reconstruct cranial bone21188 Reconstruction of midface21193 Reconst lwr jaw w/o graft21194 Reconst lwr jaw w/graft C21196 Reconst lwr jaw w/fixation21247 Reconstruct lower jaw bone21255 Reconstruct lower jaw bone21268 Revise eye sockets21343 Treatment of sinus fracture21344 Treatment of sinus fracture21346 Treat nose/jaw fracture21347 Treat nose/jaw fracture21348 Treat nose/jaw fracture21366 Treat cheek bone fracture21395 Treat eye socket fracture21422 Treat mouth roof fracture21423 Treat mouth roof fracture21431 Treat craniofacial fracture21432 Treat craniofacial fracture21433 Treat craniofacial fracture21435 Treat craniofacial fracture21436 Treat craniofacial fracture21510 Drainage of bone lesion21615 Removal of rib21616 Removal of rib and nerves21620 Partial removal of sternum21627 Sternal debridement21630 Extensive sternum surgery21632 Extensive sternum surgery21705 Revision of neck muscle/rib21740 Reconstruction of sternum21750 Repair of sternum separation21810 Treatment of rib fracture(s)21825 Treat sternum fracture22010 "I&d, p-spine, c/t/cerv-thor"22015 "I&d, p-spine, l/s/ls"22110 Remove part of neck vertebra22112 "Remove part, thorax vertebra"22114 "Remove part, lumbar vertebra"22116 Remove extra spine segment22206 "Cut spine 3 col, thor"22207 "Cut spine 3 col, lumb"22208 "Cut spine 3 col, addl seg"22210 Revision of neck spine22212 Revision of thorax spine22214 Revision of lumbar spine22216 "Revise, extra spine segment"22220 Revision of neck spine22224 Revision of lumbar spineGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 3

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201022226 "Revise, extra spine segment"22318 Treat odontoid fx w/o graft22319 Treat odontoid fx w/graft22325 Treat spine fracture22326 Treat neck spine fracture22327 Treat thorax spine fracture22328 Treat each add spine fx22532 Lat thorax spine fusion22533 Lat lumbar spine fusion22534 "Lat thor/lumb, addl seg"22548 Neck spine fusion22554 Neck spine fusion22556 Thorax spine fusion22558 Lumbar spine fusion22585 Additional spinal fusion22590 Spine & skull spinal fusion22595 Neck spinal fusion22600 Neck spine fusion22610 Thorax spine fusion22630 Lumbar spine fusion22632 "Spine fusion, extra segment"22800 Fusion of spine22802 Fusion of spine22804 Fusion of spine22808 Fusion of spine22810 Fusion of spine22812 Fusion of spine22818 "Kyphectomy, 1-2 segments"22819 "Kyphectomy, 3 or more"22830 Exploration of spinal fusion22840 Insert spine fixation device22841 Insert spine fixation device22842 Insert spine fixation device22843 Insert spine fixation device22844 Insert spine fixation device22845 Insert spine fixation device22846 Insert spine fixation device22847 Insert spine fixation device22848 Insert pelv fixation device22849 Reinsert spinal fixation22850 Remove spine fixation device22852 Remove spine fixation device22855 Remove spine fixation device22856 Cerv artific diskectomy22857 Lumbar artif diskectomy22861 Revise cerv artific disc22862 Revise lumbar artif disc22864 Remove cerv artif disc22865 Remove lumb artif disc23200 Resect clavicle tumor23210 Resect scapula tumor23220 Resect prox humerus tumor23332 Remove shoulder foreign body23472 Reconstruct shoulder jointGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 4

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201023900 Amputation of arm & girdle23920 Amputation at shoulder joint24900 Amputation of upper arm24920 Amputation of upper arm24930 Amputation follow-up surgery24931 Amputate upper arm & implant24940 Revision of upper arm25900 Amputation of forearm25905 Amputation of forearm25909 Amputation follow-up surgery25915 Amputation of forearm25920 Amputate hand at wrist25924 Amputation follow-up surgery25927 Amputation of hand26551 Great toe-hand transfer26553 "Single transfer, toe-hand"26554 "Double transfer, toe-hand"26556 Toe joint transfer26992 Drainage of bone lesion27005 Incision of hip tendon27025 Incision of hip/thigh fascia27030 Drainage of hip joint27036 Excision of hip joint/muscle27054 Removal of hip joint lining27070 Partial removal of hip bone27071 Partial removal of hip bone27075 Resect hip tumor27076 Resect hip tum incl acetabul27077 Resect hip tum w/innom bone27078 Rsect hip tum incl femur27090 Removal of hip prosthesis27091 Removal of hip prosthesis27120 Reconstruction of hip socket27122 Reconstruction of hip socket27125 Partial hip replacement27130 Total hip arthroplasty27132 Total hip arthroplasty27134 Revise hip joint replacement27137 Revise hip joint replacement27138 Revise hip joint replacement27140 Transplant femur ridge27146 Incision of hip bone27147 Revision of hip bone27151 Incision of hip bones27156 Revision of hip bones27158 Revision of pelvis27161 Incision of neck of femur27165 Incision/fixation of femur27170 Repair/graft femur head/neck27175 Treat slipped epiphysis27176 Treat slipped epiphysis27177 Treat slipped epiphysis27178 Treat slipped epiphysis27181 Treat slipped epiphysisGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 5

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201027185 Revision of femur epiphysis27187 Reinforce hip bones27222 Treat hip socket fracture27226 Treat hip wall fracture27227 Treat hip fracture(s)27228 Treat hip fracture(s)27232 Treat thigh fracture27236 Treat thigh fracture27240 Treat thigh fracture27244 Treat thigh fracture27245 Treat thigh fracture27248 Treat thigh fracture27253 Treat hip dislocation27254 Treat hip dislocation27258 Treat hip dislocation27259 Treat hip dislocation27268 Cltx thigh fx w/mnpj27269 Optx thigh fx27280 Fusion of sacroiliac joint27282 Fusion of pubic bones27284 Fusion of hip joint27286 Fusion of hip joint27290 Amputation of leg at hip27295 Amputation of leg at hip27303 Drainage of bone lesion27365 Resect femur/knee tumor27445 Revision of knee joint27447 Total knee arthroplasty27448 Incision of thigh27450 Incision of thigh27454 Realignment of thigh bone27455 Realignment of knee27457 Realignment of knee27465 Shortening of thigh bone27466 Lengthening of thigh bone27468 Shorten/lengthen thighs27470 Repair of thigh27472 Repair/graft of thigh27477 Surgery to stop leg growth27485 Surgery to stop leg growth27486 Revise/replace knee joint27487 Revise/replace knee joint27488 Removal of knee prosthesis27495 Reinforce thigh27506 Treatment of thigh fracture27507 Treatment of thigh fracture27511 Treatment of thigh fracture27513 Treatment of thigh fracture27514 Treatment of thigh fracture27519 Treat thigh fx growth plate27535 Treat knee fracture27536 Treat knee fracture27540 Treat knee fracture27556 Treat knee dislocationGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 6

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201027557 Treat knee dislocation27558 Treat knee dislocation27580 Fusion of knee27590 Amputate leg at thigh27591 Amputate leg at thigh27592 Amputate leg at thigh27596 Amputation follow-up surgery27598 Amputate lower leg at knee27645 Resect tibia tumor27646 Resect fibula tumor27702 Reconstruct ankle joint27703 "Reconstruction, ankle joint"27712 Realignment of lower leg27715 Revision of lower leg27724 Repair/graft of tibia27725 Repair of lower leg27727 Repair of lower leg27880 Amputation of lower leg27881 Amputation of lower leg27882 Amputation of lower leg27886 Amputation follow-up surgery27888 Amputation of foot at ankle28800 Amputation of midfoot31225 Removal of upper jaw31230 Removal of upper jaw31290 "Nasal/sinus endoscopy, surg"31291 "Nasal/sinus endoscopy, surg"31360 Removal of larynx31365 Removal of larynx31367 Partial removal of larynx31368 Partial removal of larynx31370 Partial removal of larynx31375 Partial removal of larynx31380 Partial removal of larynx31382 Partial removal of larynx31390 Removal of larynx & pharynx31395 Reconstruct larynx & pharynx31584 Treat larynx fracture31587 Revision of larynx31725 Clearance of airways31760 Repair of windpipe31766 Reconstruction of windpipe31770 Repair/graft of bronchus31775 Reconstruct bronchus31780 Reconstruct windpipe31781 Reconstruct windpipe31786 Remove windpipe lesion31800 Repair of windpipe injury31805 Repair of windpipe injury32035 Exploration of chest32036 Exploration of chest32095 Biopsy through chest wall32100 Exploration/biopsy of chest32110 Explore/repair chestGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 7

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201032120 Re-exploration of chest32124 Explore chest free adhesions32140 Removal of lung lesion(s)32141 Remove/treat lung lesions32150 Removal of lung lesion(s)32151 Remove lung foreign body32160 Open chest heart massage32200 "Drain, open, lung lesion"32215 Treat chest lining32220 Release of lung32225 Partial release of lung32310 Removal of chest lining32320 Free/remove chest lining32402 Open biopsy chest lining32440 Removal of lung32442 Sleeve pneumonectomy32445 Removal of lung32480 Partial removal of lung32482 Bilobectomy32484 Segmentectomy32486 Sleeve lobectomy32488 Completion pneumonectomy32491 Lung volume reduction32500 Partial removal of lung32501 Repair bronchus add-on32503 Resect apical lung tumor32504 Resect apical lung tum/chest32540 Removal of lung lesion32650 "Thoracoscopy, surgical"32651 "Thoracoscopy, surgical"32652 "Thoracoscopy, surgical"32653 "Thoracoscopy, surgical"32654 "Thoracoscopy, surgical"32655 "Thoracoscopy, surgical"32656 "Thoracoscopy, surgical"32657 "Thoracoscopy, surgical"32658 "Thoracoscopy, surgical"32659 "Thoracoscopy, surgical"32660 "Thoracoscopy, surgical"32661 "Thoracoscopy, surgical"32662 "Thoracoscopy, surgical"32663 "Thoracoscopy, surgical"32664 "Thoracoscopy, surgical"32665 "Thoracoscopy, surgical"32800 Repair lung hernia32810 Close chest after drainage32815 Close bronchial fistula32820 Reconstruct injured chest32850 Donor pneumonectomy32851 "Lung transplant, single"32852 Lung transplant with bypass32853 "Lung transplant, double"32854 Lung transplant with bypass32855 "Prepare donor lung, single"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 8

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201032856 "Prepare donor lung, double"32900 Removal of rib(s)32905 Revise & repair chest wall32906 Revise & repair chest wall32940 Revision of lung C32997 Total lung lavage33015 Incision of heart sac33020 Incision of heart sac33025 Incision of heart sac33030 Partial removal of heart sac33031 Partial removal of heart sac33050 Removal of heart sac lesion33120 Removal of heart lesion33130 Removal of heart lesion33140 Heart revascularize (tmr)33141 Heart tmr w/other procedure33202 "Insert epicard eltrd, open"33203 "Insert epicard eltrd, endo"33236 Remove electrode/thoracotomy33237 Remove electrode/thoracotomy33238 Remove electrode/thoracotomy33243 Remove eltrd/thoracotomy33250 Ablate heart dysrhythm focus33251 Ablate heart dysrhythm focus33254 "Ablate atria, lmtd"33255 "Ablate atria w/o bypass, ext"33256 "Ablate atria w/bypass, exten"33257 "Ablate atria, lmtd, add-on"33258 "Ablate atria, x10sv, add-on"33259 Ablate atria w/bypass add-on33261 Ablate heart dysrhythm focus33265 "Ablate atria, lmtd, endo"33266 "Ablate atria, x10sv, endo"33300 Repair of heart wound33305 Repair of heart wound33310 Exploratory heart surgery33315 Exploratory heart surgery33320 Repair major blood vessel(s)33321 Repair major vessel33322 Repair major blood vessel(s)33330 Insert major vessel graft33332 Insert major vessel graft33335 Insert major vessel graft33400 Repair of aortic valve33401 "Valvuloplasty, open"33403 "Valvuloplasty, w/cp bypass"33404 Prepare heart-aorta conduit33405 Replacement of aortic valve33406 Replacement of aortic valve33410 Replacement of aortic valve33411 Replacement of aortic valve33412 Replacement of aortic valve33413 Replacement of aortic valve33414 Repair of aortic valveGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 9

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201033415 "Revision, subvalvular tissue"33416 Revise ventricle muscle33417 Repair of aortic valve33420 Revision of mitral valve33422 Revision of mitral valve33425 Repair of mitral valve33426 Repair of mitral valve33427 Repair of mitral valve33430 Replacement of mitral valve33460 Revision of tricuspid valve33463 "Valvuloplasty, tricuspid"33464 "Valvuloplasty, tricuspid"33465 Replace tricuspid valve33468 Revision of tricuspid valve33470 Revision of pulmonary valve33471 "Valvotomy, pulmonary valve"33472 Revision of pulmonary valve33474 Revision of pulmonary valve33475 "Replacement, pulmonary valve33476 Revision of heart chamber33478 Revision of heart chamber33496 "Repair, prosth valve clot"33500 Repair heart vessel fistula33501 Repair heart vessel fistula33502 Coronary artery correction33503 Coronary artery graft33504 Coronary artery graft33505 Repair artery w/tunnel33506 "Repair artery, translocation"33507 "Repair art, intramural"33510 "CABG, vein, single"33511 "CABG, vein, two"33512 "CABG, vein, three"33513 "CABG, vein, four"33514 "CABG, vein, five"33516 "Cabg, vein, six or more"33517 "CABG, artery-vein, single"33518 "CABG, artery-vein, two"33519 "CABG, artery-vein, three"33521 "CABG, artery-vein, four"33522 "CABG, artery-vein, five"33523 "Cabg, art-vein, six or more"33530 "Coronary artery, bypass/reop"33533 "CABG, arterial, single"33534 "CABG, arterial, two"33535 "CABG, arterial, three"33536 "Cabg, arterial, four or more"33542 Removal of heart lesion33545 Repair of heart damage33548 "Restore/remodel, ventricle"33572 Open coronary endarterectomy33600 Closure of valve33602 Closure of valve33606 Anastomosis/artery-aortaGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 10

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201033608 Repair anomaly w/conduit33610 Repair by enlargement33611 Repair double ventricle33612 Repair double ventricle33615 "Repair, modified fontan"33617 Repair single ventricle33619 Repair single ventricle33641 Repair heart septum defect33645 Revision of heart veins33647 Repair heart septum defects33660 Repair of heart defects33665 Repair of heart defects33670 Repair of heart chambers33675 Close mult vsd33676 Close mult vsd w/resection33677 Cl mult vsd w/rem pul band33681 Repair heart septum defect33684 Repair heart septum defect33688 Repair heart septum defect33690 Reinforce pulmonary artery33692 Repair of heart defects33694 Repair of heart defects33697 Repair of heart defects33702 Repair of heart defects33710 Repair of heart defects33720 Repair of heart defect33722 Repair of heart defect33724 Repair venous anomaly33726 Repair pul venous stenosis33730 Repair heart-vein defect(s)33732 Repair heart-vein defect33735 Revision of heart chamber33736 Revision of heart chamber33737 Revision of heart chamber33750 Major vessel shunt33755 Major vessel shunt33762 Major vessel shunt33764 Major vessel shunt & graft33766 Major vessel shunt33767 Major vessel shunt33768 Cavopulmonary shunting33770 Repair great vessels defect33771 Repair great vessels defect33774 Repair great vessels defect33775 Repair great vessels defect33776 Repair great vessels defect33777 Repair great vessels defect33778 Repair great vessels defect33779 Repair great vessels defect33780 Repair great vessels defect33781 Repair great vessels defect33782 Nikaidoh proc NI33783 Nikaidoh proc w/ostia implt33786 Repair arterial trunkGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 11

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201033788 Revision of pulmonary artery33800 Aortic suspension33802 Repair vessel defect33803 Repair vessel defect33813 Repair septal defect33814 Repair septal defect33820 Revise major vessel33822 Revise major vessel33824 Revise major vessel33840 Remove aorta constriction33845 Remove aorta constriction33851 Remove aorta constriction33852 Repair septal defect33853 Repair septal defect33860 Ascending aortic graft33861 Ascending aortic graft33863 Ascending aortic graft33864 Ascending aortic graft33870 Transverse aortic arch graft33875 Thoracic aortic graft33877 Thoracoabdominal graft33880 Endovasc taa repr incl subcl33881 Endovasc taa repr w/o subcl33883 "Insert endovasc prosth, taa"33884 "Endovasc prosth, taa, add-on"33886 "Endovasc prosth, delayed"33889 Artery transpose/endovas taa33891 Car-car bp grft/endovas taa33910 Remove lung artery emboli33915 Remove lung artery emboli33916 Surgery of great vessel33917 Repair pulmonary artery33920 Repair pulmonary atresia33922 Transect pulmonary artery33924 Remove pulmonary shunt33925 Rpr pul art unifocal w/o cpb33926 "Repr pul art, unifocal w/cpb"33930 Removal of donor heart/lung33933 Prepare donor heart/lung33935 "Transplantation, heart/lung"33940 Removal of donor heart33944 Prepare donor heart33945 Transplantation of heart33960 External circulation assist33961 External circulation assist33967 Insert ia percut device33968 Remove aortic assist device33970 Aortic circulation assist33971 Aortic circulation assist33973 Insert balloon device33974 Remove intra-aortic balloon33975 Implant ventricular device33976 Implant ventricular device33977 Remove ventricular deviceGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 12

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201033978 Remove ventricular device33979 Insert intracorporeal device33980 Remove intracorporeal device33981 Replace vad pump ext33982 Replace vad intra w/o bp33983 Replace vad intra w/bp34001 Removal of artery clot34051 Removal of artery clot34151 Removal of artery clot34401 Removal of vein clot34451 Removal of vein clot34502 Reconstruct vena cava34800 Endovas aaa repr w/sm tube34802 Endovas aaa repr w/2-p part34803 Endovas aaa repr w/3-p part34804 Endovas aaa repr w/1-p part34805 Endovas aaa repr w/long tube34806 Aneurysm press sensor add-on34808 Endovas iliac a device addon34812 "Xpose for endoprosth, femorl"34813 Femoral endovas graft add-on34820 "Xpose for endoprosth, iliac"34825 "Endovasc extend prosth, init"34826 "Endovasc exten prosth, addl"34830 Open aortic tube prosth repr34831 Open aortoiliac prosth repr34832 Open aortofemor prosth repr34833 "Xpose for endoprosth, iliac"34834 "Xpose, endoprosth, brachial"34900 Endovasc iliac repr w/graft35001 Repair defect of artery35002 "Repair artery rupture, neck"35005 Repair defect of artery35013 "Repair artery rupture, arm"35021 Repair defect of artery35022 "Repair artery rupture, chest"35045 Repair defect of arm artery35081 Repair defect of artery35082 "Repair artery rupture, aorta"35091 Repair defect of artery35092 "Repair artery rupture, aorta"35102 Repair defect of artery35103 "Repair artery rupture, groin"35111 Repair defect of artery35112 "Repair artery rupture,spleen"35121 Repair defect of artery35122 "Repair artery rupture, belly"35131 Repair defect of artery35132 "Repair artery rupture, groin"35141 Repair defect of artery35142 "Repair artery rupture, thigh"35151 Repair defect of artery35152 "Repair artery rupture, knee"35182 Repair blood vessel lesionGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 13

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201035189 Repair blood vessel lesion35211 Repair blood vessel lesion35216 Repair blood vessel lesion35221 Repair blood vessel lesion35241 Repair blood vessel lesion35246 Repair blood vessel lesion35251 Repair blood vessel lesion35271 Repair blood vessel lesion35276 Repair blood vessel lesion35281 Repair blood vessel lesion35301 Rechanneling of artery35302 Rechanneling of artery35303 Rechanneling of artery35304 Rechanneling of artery35305 Rechanneling of artery35306 Rechanneling of artery35311 Rechanneling of artery35331 Rechanneling of artery35341 Rechanneling of artery35351 Rechanneling of artery35355 Rechanneling of artery35361 Rechanneling of artery35363 Rechanneling of artery35371 Rechanneling of artery35372 Rechanneling of artery35390 "Reoperation, carotid add-on"35400 Angioscopy35450 Repair arterial blockage35452 Repair arterial blockage35454 Repair arterial blockage35456 Repair arterial blockage35480 "Atherectomy, open"35481 "Atherectomy, open"35482 "Atherectomy, open"35483 "Atherectomy, open"35501 Artery bypass graft35506 Artery bypass graft35508 Artery bypass graft35509 Artery bypass graft35510 Artery bypass graft35511 Artery bypass graft35512 Artery bypass graft35515 Artery bypass graft35516 Artery bypass graft35518 Artery bypass graft35521 Artery bypass graft35522 Artery bypass graft35523 Artery bypass graft35525 Artery bypass graft35526 Artery bypass graft35531 Artery bypass graft35533 Artery bypass graft35535 Artery bypass graft35536 Artery bypass graftGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 14

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201035537 Artery bypass graft35538 Artery bypass graft35539 Artery bypass graft35540 Artery bypass graft35548 Artery bypass graft35549 Artery bypass graft35551 Artery bypass graft35556 Artery bypass graft35558 Artery bypass graft35560 Artery bypass graft35563 Artery bypass graft35565 Artery bypass graft35566 Artery bypass graft35570 Artery bypass graft35571 Artery bypass graft35583 Vein bypass graft35585 Vein bypass graft35587 Vein bypass graft35600 Harvest art for cabg add-on35601 Artery bypass graft35606 Artery bypass graft35612 Artery bypass graft35616 Artery bypass graft35621 Artery bypass graft35623 "Bypass graft, not vein"35626 Artery bypass graft35631 Artery bypass graft35632 Artery bypass graft35633 Artery bypass graft35634 Artery bypass graft35636 Artery bypass graft35637 Artery bypass graft35638 Artery bypass graft35642 Artery bypass graft35645 Artery bypass graft35646 Artery bypass graft35647 Artery bypass graft35650 Artery bypass graft35651 Artery bypass graft35654 Artery bypass graft35656 Artery bypass graft35661 Artery bypass graft35663 Artery bypass graft35665 Artery bypass graft35666 Artery bypass graft35671 Artery bypass graft35681 Composite bypass graft35682 Composite bypass graft35683 Composite bypass graft35691 Arterial transposition35693 Arterial transposition35694 Arterial transposition35695 Arterial transposition35697 Reimplant artery eachGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 15

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201035700 "Reoperation, bypass graft"35701 "Exploration, carotid artery"35721 "Exploration, femoral artery"35741 Exploration popliteal artery35800 Explore neck vessels35820 Explore chest vessels35840 Explore abdominal vessels35870 Repair vessel graft defect35901 "Excision, graft, neck"35905 "Excision, graft, thorax"35907 "Excision, graft, abdomen"36660 "Insertion catheter, artery"36822 Insertion of cannula(s)36823 Insertion of cannula(s)37140 Revision of circulation37145 Revision of circulation37160 Revision of circulation37180 Revision of circulation37181 Splice spleen/kidney veins37182 Insert hepatic shunt (tips)37616 Ligation of chest artery37617 Ligation of abdomen artery37618 Ligation of extremity artery37660 Revision of major vein37788 "Revascularization, penis"38100 "Removal of spleen, total"38101 "Removal of spleen, partial"38102 "Removal of spleen, total"38115 Repair of ruptured spleen38380 Thoracic duct procedure38381 Thoracic duct procedure38382 Thoracic duct procedure38562 "Removal, pelvic lymph nodes"38564 "Removal, abdomen lymph nod38724 "Removal of lymph nodes, neck"38746 Remove thoracic lymph nodes38747 Remove abdominal lymph node38765 Remove groin lymph nodes38770 Remove pelvis lymph nodes38780 Remove abdomen lymph nodes39000 Exploration of chest39010 Exploration of chest39200 Removal chest lesion39220 Removal chest lesion39499 Chest procedure39501 Repair diaphragm laceration39502 Repair paraesophageal hernia39503 Repair of diaphragm hernia39520 Repair of diaphragm hernia39530 Repair of diaphragm hernia39531 Repair of diaphragm hernia39540 Repair of diaphragm hernia39541 Repair of diaphragm hernia39545 Revision of diaphragmGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 16

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201039560 "Resect diaphragm, simple"39561 "Resect diaphragm, complex"39599 Diaphragm surgery procedure41130 Partial removal of tongue41135 Tongue and neck surgery41140 Removal of tongue41145 "Tongue removal, neck surgery"41150 "Tongue, mouth, jaw surgery"41153 "Tongue, mouth, neck surgery"41155 "Tongue, jaw, & neck surgery"42426 Excise parotid gland/lesion42845 Extensive surgery of throat42894 Revision of pharyngeal walls42953 "Repair throat, esophagus"42961 Control throat bleeding42971 Control nose/throat bleeding43045 Incision of esophagus43100 Excision of esophagus lesion43101 Excision of esophagus lesion43107 Removal of esophagus43108 Removal of esophagus43112 Removal of esophagus43113 Removal of esophagus43116 Partial removal of esophagus43117 Partial removal of esophagus43118 Partial removal of esophagus43121 Partial removal of esophagus43122 Partial removal of esophagus43123 Partial removal of esophagus43124 Removal of esophagus43135 Removal of esophagus pouch43279 "Lap myotomy, heller"43281 Lap paraesophag hern repair43282 Lap paraesoph her rpr w/mesh43300 Repair of esophagus43305 Repair esophagus and fistula43310 Repair of esophagus43312 Repair esophagus and fistula43313 Esophagoplasty congenital43314 Tracheo-esophagoplasty cong43320 Fuse esophagus & stomach43324 Revise esophagus & stomach43325 Revise esophagus & stomach43326 Revise esophagus & stomach43330 Repair of esophagus43331 Repair of esophagus43340 Fuse esophagus & intestine43341 Fuse esophagus & intestine43350 "Surgical opening, esophagus"43351 "Surgical opening, esophagus"43352 "Surgical opening, esophagus"43360 Gastrointestinal repair43361 Gastrointestinal repair43400 Ligate esophagus veinsGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 17

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201043401 Esophagus surgery for veins43405 Ligate/staple esophagus43410 Repair esophagus wound43415 Repair esophagus wound43425 Repair esophagus opening43460 Pressure treatment esophagus43496 "Free jejunum flap, microvasc"43500 Surgical opening of stomach43501 Surgical repair of stomach43502 Surgical repair of stomach43520 Incision of pyloric muscle43605 Biopsy of stomach43610 Excision of stomach lesion43611 Excision of stomach lesion43620 Removal of stomach43621 Removal of stomach43622 Removal of stomach43631 "Removal of stomach, partial"43632 "Removal of stomach, partial"43633 "Removal of stomach, partial"43634 "Removal of stomach, partial"43635 "Removal of stomach, partial"43640 Vagotomy & pylorus repair43641 Vagotomy & pylorus repair43644 Lap gastric bypass/roux-en-y43645 Lap gastr bypass incl smll i43770 Lap place gastr adj device43771 Lap revise gastr adj device43772 Lap rmvl gastr adj device43773 Lap replace gastr adj device43774 Lap rmvl gastr adj all parts43775 Lap sleeve gastrectomy43800 Reconstruction of pylorus43810 Fusion of stomach and bowel43820 Fusion of stomach and bowel43825 Fusion of stomach and bowel43832 Place gastrostomy tube C43840 Repair of stomach lesion43843 Gastroplasty w/o v-band43845 Gastroplasty duodenal switch43846 Gastric bypass for obesity43847 Gastric bypass incl small i43848 Revision gastroplasty43850 Revise stomach-bowel fusion43855 Revise stomach-bowel fusion43860 Revise stomach-bowel fusion43865 Revise stomach-bowel fusion43880 Repair stomach-bowel fistula43881 "Impl/redo electrd, antrum"43882 Revise/remove electrd antrum44005 Freeing of bowel adhesion44010 Incision of small bowel44015 Insert needle cath bowel44020 Explore small intestineGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 18

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201044021 Decompress small bowel44025 Incision of large bowel44050 Reduce bowel obstruction44055 Correct malrotation of bowel44110 Excise intestine lesion(s)44111 Excision of bowel lesion(s)44120 Removal of small intestine44121 Removal of small intestine44125 Removal of small intestine44126 "Enterectomy w/o taper, cong"44127 "Enterectomy w/taper, cong"44128 "Enterectomy cong, add-on"44130 Bowel to bowel fusion44132 "Enterectomy, cadaver donor"44133 "Enterectomy, live donor"44135 "Intestine transplnt, cadaver"44136 "Intestine transplant, live"44137 Remove intestinal allograft44139 Mobilization of colon44140 Partial removal of colon44141 Partial removal of colon44143 Partial removal of colon44144 Partial removal of colon44145 Partial removal of colon44146 Partial removal of colon44147 Partial removal of colon44150 Removal of colon44151 Removal of colon/ileostomy44155 Removal of colon/ileostomy44156 Removal of colon/ileostomy44157 Colectomy w/ileoanal anast44158 Colectomy w/neo-rectum pouch44160 Removal of colon44187 "Lap, ileo/jejuno-stomy"44188 "Lap, colostomy"44202 "Lap, enterectomy"44203 "Lap resect s/intestine, addl"44204 Laparo partial colectomy44205 Lap colectomy part w/ileum44210 Laparo total proctocolectomy44211 Lap colectomy w/proctectomy44212 Laparo total proctocolectomy44227 "Lap, close enterostomy"44300 Open bowel to skin44310 Ileostomy/jejunostomy44314 Revision of ileostomy44316 Devise bowel pouch44320 Colostomy44322 Colostomy with biopsies44345 Revision of colostomy44346 Revision of colostomy44602 "Suture, small intestine"44603 "Suture, small intestine"44604 "Suture, large intestine"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 19

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201046742 Repair of imperforated anus46744 Repair of cloacal anomaly46746 Repair of cloacal anomaly46748 Repair of cloacal anomaly46751 Repair of anal sphincter47010 "Open drainage, liver lesion"47015 Inject/aspirate liver cyst47100 Wedge biopsy of liver47120 Partial removal of liver47122 Extensive removal of liver47125 Partial removal of liver47130 Partial removal of liver47133 Removal of donor liver47135 Transplantation of liver47136 Transplantation of liver47140 "Partial removal, donor liver"47141 "Partial removal, donor liver"47142 "Partial removal, donor liver"47143 "Prep donor liver, whole"47144 "Prep donor liver, 3-segment"47145 "Prep donor liver, lobe split"47146 Prep donor liver/venous47147 Prep donor liver/arterial47300 Surgery for liver lesion47350 Repair liver wound47360 Repair liver wound47361 Repair liver wound47362 Repair liver wound47380 Open ablate liver tumor rf47381 Open ablate liver tumor cryo47400 Incision of liver duct47420 Incision of bile duct47425 Incision of bile duct47460 Incise bile duct sphincter47480 Incision of gallbladder47550 Bile duct endoscopy add-on47570 Laparo cholecystoenterostomy47600 Removal of gallbladder47605 Removal of gallbladder47610 Removal of gallbladder47612 Removal of gallbladder47620 Removal of gallbladder47700 Exploration of bile ducts47701 Bile duct revision47711 Excision of bile duct tumor47712 Excision of bile duct tumor47715 Excision of bile duct cyst47720 Fuse gallbladder & bowel47721 Fuse upper gi structures C47740 Fuse gallbladder & bowel47741 Fuse gallbladder & bowel47760 Fuse bile ducts and bowel47765 Fuse liver ducts & bowel47780 Fuse bile ducts and bowelGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 21

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201047785 Fuse bile ducts and bowel47800 Reconstruction of bile ducts47801 "Placement, bile duct support"47802 Fuse liver duct & intestine47900 Suture bile duct injury48000 Drainage of abdomen48001 "Placement of drain, pancreas"48020 Removal of pancreatic stone48100 "Biopsy of pancreas, open"48105 Resect/debride pancreas48120 Removal of pancreas lesion48140 Partial removal of pancreas48145 Partial removal of pancreas48146 Pancreatectomy48148 Removal of pancreatic duct48150 Partial removal of pancreas48152 Pancreatectomy48153 Pancreatectomy48154 Pancreatectomy48155 Removal of pancreas48400 "Injection, intraop add-on"48500 Surgery of pancreatic cyst48510 Drain pancreatic pseudocyst48520 Fuse pancreas cyst and bowel48540 Fuse pancreas cyst and bowel48545 Pancreatorrhaphy48547 Duodenal exclusion48548 Fuse pancreas and bowel48551 Prep donor pancreas48552 Prep donor pancreas/venous48554 Transpl allograft pancreas48556 "Removal, allograft pancreas"49000 Exploration of abdomen49002 Reopening of abdomen49010 Exploration behind abdomen49020 Drain abdominal abscess49040 "Drain, open, abdom abscess"49060 "Drain, open, retrop abscess"49062 Drain to peritoneal cavity49203 Exc abd tum 5 cm or less49204 Exc abd tum over 5 cm49205 Exc abd tum over 10 cm49215 Excise sacral spine tumor49220 "Multiple surgery, abdomen"49255 Removal of omentum49425 Insert abdomen-venous drain49428 Ligation of shunt49605 Repair umbilical lesion49606 Repair umbilical lesion49610 Repair umbilical lesion49611 Repair umbilical lesion49900 Repair of abdominal wall49904 "Omental flap, extra-abdom"49905 "Omental flap, intra-abdom"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 22

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201049906 "Free omental flap, microvasc"50010 Exploration of kidney50040 Drainage of kidney50045 Exploration of kidney50060 Removal of kidney stone50065 Incision of kidney50070 Incision of kidney50075 Removal of kidney stone50100 Revise kidney blood vessels50120 Exploration of kidney50125 Explore and drain kidney50130 Removal of kidney stone50135 Exploration of kidney50205 Renal biopsy open50220 "Remove kidney, open"50225 "Removal kidney open, complex50230 "Removal kidney open, radical"50234 Removal of kidney & ureter50236 Removal of kidney & ureter50240 Partial removal of kidney50250 Cryoablate renal mass open50280 Removal of kidney lesion50290 Removal of kidney lesion50300 Remove cadaver donor kidney50320 "Remove kidney, living donor"50323 Prep cadaver renal allograft50325 Prep donor renal graft50327 Prep renal graft/venous50328 Prep renal graft/arterial50329 Prep renal graft/ureteral50340 Removal of kidney50360 Transplantation of kidney50365 Transplantation of kidney50370 Remove transplanted kidney50380 Reimplantation of kidney50400 Revision of kidney/ureter50405 Revision of kidney/ureter50500 Repair of kidney wound50520 Close kidney-skin fistula50525 Repair renal-abdomen fistula50526 Repair renal-abdomen fistula50540 Revision of horseshoe kidney50545 Laparo radical nephrectomy50546 Laparoscopic nephrectomy50547 Laparo removal donor kidney50548 Laparo remove w/ureter50600 Exploration of ureter50605 Insert ureteral support50610 Removal of ureter stone50620 Removal of ureter stone50630 Removal of ureter stone50650 Removal of ureter50660 Removal of ureter50700 Revision of ureterGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 23

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201050715 Release of ureter50722 Release of ureter50725 Release/revise ureter50728 Revise ureter50740 Fusion of ureter & kidney50750 Fusion of ureter & kidney50760 Fusion of ureters50770 Splicing of ureters50780 Reimplant ureter in bladder50782 Reimplant ureter in bladder50783 Reimplant ureter in bladder50785 Reimplant ureter in bladder50800 Implant ureter in bowel50810 Fusion of ureter & bowel50815 Urine shunt to intestine50820 Construct bowel bladder50825 Construct bowel bladder50830 Revise urine flow50840 Replace ureter by bowel50845 Appendico-vesicostomy50860 Transplant ureter to skin50900 Repair of ureter50920 Closure ureter/skin fistula50930 Closure ureter/bowel fistula50940 Release of ureter51525 Removal of bladder lesion51530 Removal of bladder lesion51550 Partial removal of bladder51555 Partial removal of bladder51565 Revise bladder & ureter(s)51570 Removal of bladder51575 Removal of bladder & nodes51580 Remove bladder/revise tract51585 Removal of bladder & nodes51590 Remove bladder/revise tract51595 Remove bladder/revise tract51596 Remove bladder/create pouch51597 Removal of pelvic structures51800 Revision of bladder/urethra51820 Revision of urinary tract51840 Attach bladder/urethra51841 Attach bladder/urethra51865 Repair of bladder wound51900 Repair bladder/vagina lesion51920 Close bladder-uterus fistula51925 Hysterectomy/bladder repair51940 Correction of bladder defect51960 Revision of bladder & bowel51980 Construct bladder opening53415 Reconstruction of urethra53448 Remov/replc ur sphinctr comp54125 Removal of penis54130 Remove penis & nodes54135 Remove penis & nodesGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 24

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201054390 Repair penis and bladder54411 "Remov/replc penis pros, comp"54417 "Remv/replc penis pros, compl"54430 Revision of penis54650 Orchiopexy (Fowler-Stephens)55605 Incise sperm duct pouch55650 Remove sperm duct pouch55801 Removal of prostate55810 Extensive prostate surgery55812 Extensive prostate surgery55815 Extensive prostate surgery55821 Removal of prostate55831 Removal of prostate55840 Extensive prostate surgery55842 Extensive prostate surgery55845 Extensive prostate surgery55862 Extensive prostate surgery55865 Extensive prostate surgery55866 Laparo radical prostatectomy56630 Extensive vulva surgery56631 Extensive vulva surgery56632 Extensive vulva surgery56633 Extensive vulva surgery56634 Extensive vulva surgery56637 Extensive vulva surgery56640 Extensive vulva surgery57110 "Remove vagina wall, complete"57111 "Remove vagina tissue, compl"57112 "Vaginectomy w/nodes, compl"57270 Repair of bowel pouch57280 Suspension of vagina57296 "Revise vag graft, open abd"57305 Repair rectum-vagina fistula57307 Fistula repair & colostomy57308 "Fistula repair, transperine"57311 Repair urethrovaginal lesion57531 "Removal of cervix, radical"57540 Removal of residual cervix57545 Remove cervix/repair pelvis58140 Myomectomy abdom method58146 Myomectomy abdom complex58150 Total hysterectomy58152 Total hysterectomy58180 Partial hysterectomy58200 Extensive hysterectomy58210 Extensive hysterectomy58240 Removal of pelvis contents58267 Vag hyst w/urinary repair58275 Hysterectomy/revise vagina58280 Hysterectomy/revise vagina58285 Extensive hysterectomy58293 "Vag hyst w/uro repair, compl"58400 Suspension of uterus58410 Suspension of uterusGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 25

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201061108 Drill skull for drainage61120 Burr hole for puncture61140 Pierce skull for biopsy61150 Pierce skull for drainage61151 Pierce skull for drainage61154 Pierce skull & remove clot61156 Pierce skull for drainage61210 "Pierce skull, implant device"61250 Pierce skull & explore61253 Pierce skull & explore61304 Open skull for exploration61305 Open skull for exploration61312 Open skull for drainage61313 Open skull for drainage61314 Open skull for drainage61315 Open skull for drainage61316 Implt cran bone flap to abdo61320 Open skull for drainage61321 Open skull for drainage61322 Decompressive craniotomy61323 Decompressive lobectomy61332 Explore/biopsy eye socket61333 Explore orbit/remove lesion61340 Subtemporal decompression61343 Incise skull (press relief)61345 Relieve cranial pressure61440 Incise skull for surgery61450 Incise skull for surgery61458 Incise skull for brain wound61460 Incise skull for surgery61470 Incise skull for surgery61480 Incise skull for surgery61490 Incise skull for surgery61500 Removal of skull lesion61501 Remove infected skull bone61510 Removal of brain lesion61512 Remove brain lining lesion61514 Removal of brain abscess61516 Removal of brain lesion61517 Implt brain chemotx add-on61518 Removal of brain lesion61519 Remove brain lining lesion61520 Removal of brain lesion61521 Removal of brain lesion61522 Removal of brain abscess61524 Removal of brain lesion61526 Removal of brain lesion61530 Removal of brain lesion61531 Implant brain electrodes61533 Implant brain electrodes61534 Removal of brain lesion61535 Remove brain electrodes61536 Removal of brain lesion61537 Removal of brain tissueGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 27

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201061538 Removal of brain tissue61539 Removal of brain tissue61540 Removal of brain tissue61541 Incision of brain tissue61542 Removal of brain tissue61543 Removal of brain tissue61544 Remove & treat brain lesion61545 Excision of brain tumor61546 Removal of pituitary gland61548 Removal of pituitary gland61550 Release of skull seams61552 Release of skull seams61556 Incise skull/sutures61557 Incise skull/sutures61558 Excision of skull/sutures61559 Excision of skull/sutures61563 Excision of skull tumor61564 Excision of skull tumor61566 Removal of brain tissue61567 Incision of brain tissue61570 "Remove foreign body, brain"61571 Incise skull for brain wound61575 Skull base/brainstem surgery61576 Skull base/brainstem surgery61580 "Craniofacial approach, skull"61581 "Craniofacial approach, skull"61582 "Craniofacial approach, skull"61583 "Craniofacial approach, skull"61584 Orbitocranial approach/skull61585 Orbitocranial approach/skull61586 "Resect nasopharynx, skull"61590 Infratemporal approach/skull61591 Infratemporal approach/skull61592 Orbitocranial approach/skull61595 Transtemporal approach/skull61596 Transcochlear approach/skull61597 Transcondylar approach/skull61598 Transpetrosal approach/skull61600 Resect/excise cranial lesion61601 Resect/excise cranial lesion61605 Resect/excise cranial lesion61606 Resect/excise cranial lesion61607 Resect/excise cranial lesion61608 Resect/excise cranial lesion61609 "Transect artery, sinus"61610 "Transect artery, sinus"61611 "Transect artery, sinus"61612 "Transect artery, sinus"61613 "Remove aneurysm, sinus"61615 "Resect/excise lesion, skull"61616 "Resect/excise lesion, skull"61618 Repair dura61619 Repair dura61624 "Transcath occlusion, cns"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 28

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201061630 Intracranial angioplasty61635 Intracran angioplsty w/stent61680 Intracranial vessel surgery61682 Intracranial vessel surgery61684 Intracranial vessel surgery61686 Intracranial vessel surgery61690 Intracranial vessel surgery61692 Intracranial vessel surgery61697 "Brain aneurysm repr, complx"61698 "Brain aneurysm repr, complx"61700 "Brain aneurysm repr, simple"61702 Inner skull vessel surgery61703 Clamp neck artery61705 Revise circulation to head61708 Revise circulation to head61710 Revise circulation to head61711 Fusion of skull arteries61735 Incise skull/brain surgery61750 Incise skull/brain biopsy61751 Brain biopsy w/ct/mr guide61760 Implant brain electrodes61850 Implant neuroelectrodes61860 Implant neuroelectrodes61863 Implant neuroelectrode C61864 "Implant neuroelectrde, addl"61867 Implant neuroelectrode C61868 "Implant neuroelectrde, addl"61870 Implant neuroelectrodes61875 Implant neuroelectrodes62005 Treat skull fracture62010 Treatment of head injury62100 Repair brain fluid leakage62115 Reduction of skull defect62116 Reduction of skull defect62117 Reduction of skull defect62120 Repair skull cavity lesion62121 Incise skull repair62140 Repair of skull defect62141 Repair of skull defect62142 Remove skull plate/flap62143 Replace skull plate/flap62145 Repair of skull & brain62146 Repair of skull with graft62147 Repair of skull with graft62148 Retr bone flap to fix skull62161 Dissect brain w/scope62162 Remove colloid cyst w/scope62163 Neuroendoscopy w/fb removal62164 Remove brain tumor w/scope62165 Remove pituit tumor w/scope62180 Establish brain cavity shunt62190 Establish brain cavity shunt62192 Establish brain cavity shunt62200 Establish brain cavity shuntGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 29

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201062201 Brain cavity shunt w/scope62220 Establish brain cavity shunt62223 Establish brain cavity shunt62256 Remove brain cavity shunt62258 Replace brain cavity shunt63043 "Laminotomy, addl cervical"63044 "Laminotomy, addl lumbar"63050 Cervical laminoplasty63051 C-laminoplasty w/graft/plate63077 "Spine disk surgery, thorax"63078 "Spine disk surgery, thorax"63081 Removal of vertebral body63082 Remove vertebral body add-on63085 Removal of vertebral body63086 Remove vertebral body add-on63087 Removal of vertebral body63088 Remove vertebral body add-on63090 Removal of vertebral body63091 Remove vertebral body add-on63101 Removal of vertebral body63102 Removal of vertebral body63103 Remove vertebral body add-on63170 Incise spinal cord tract(s)63172 Drainage of spinal cyst63173 Drainage of spinal cyst63180 Revise spinal cord ligaments63182 Revise spinal cord ligaments63185 Incise spinal column/nerves63190 Incise spinal column/nerves63191 Incise spinal column/nerves63194 Incise spinal column & cord63195 Incise spinal column & cord63196 Incise spinal column & cord63197 Incise spinal column & cord63198 Incise spinal column & cord63199 Incise spinal column & cord63200 Release of spinal cord C63250 Revise spinal cord vessels63251 Revise spinal cord vessels63252 Revise spinal cord vessels63265 Excise intraspinal lesion63266 Excise intraspinal lesion63267 Excise intraspinal lesion63268 Excise intraspinal lesion63270 Excise intraspinal lesion63271 Excise intraspinal lesion63272 Excise intraspinal lesion63273 Excise intraspinal lesion63275 Biopsy/excise spinal tumor63276 Biopsy/excise spinal tumor63277 Biopsy/excise spinal tumor63278 Biopsy/excise spinal tumor63280 Biopsy/excise spinal tumor63281 Biopsy/excise spinal tumorGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 30

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201063282 Biopsy/excise spinal tumor63283 Biopsy/excise spinal tumor63285 Biopsy/excise spinal tumor63286 Biopsy/excise spinal tumor63287 Biopsy/excise spinal tumor63290 Biopsy/excise spinal tumor63295 Repair of laminectomy defect63300 Removal of vertebral body63301 Removal of vertebral body63302 Removal of vertebral body63303 Removal of vertebral body63304 Removal of vertebral body63305 Removal of vertebral body63306 Removal of vertebral body63307 Removal of vertebral body63308 Remove vertebral body add-on63700 Repair of spinal herniation63702 Repair of spinal herniation63704 Repair of spinal herniation63706 Repair of spinal herniation63707 Repair spinal fluid leakage63709 Repair spinal fluid leakage63710 Graft repair of spine defect63740 Install spinal shunt64752 Incision of vagus nerve64755 Incision of stomach nerves64760 Incision of vagus nerve64809 Remove sympathetic nerves64818 Remove sympathetic nerves64866 Fusion of facial/other nerve64868 Fusion of facial/other nerve65273 Repair of eye wound69155 Extensive ear/neck surgery69535 Remove part of temporal bone69554 Remove ear lesion69950 Incise inner ear nerve75900 Intravascular cath exchange75952 Endovasc repair abdom aorta75953 Abdom aneurysm endovas rpr75954 Iliac aneurysm endovas rpr75956 "Xray, endovasc thor ao repr"75957 "Xray, endovasc thor ao repr"75958 "Xray, place prox ext thor ao"75959 "Xray, place dist ext thor ao"92970 "Cardioassist, internal"92971 "Cardioassist, external"92975 "Dissolve clot, heart vessel"92992 Revision of heart chamber92993 Revision of heart chamber99190 Special pump services99191 Special pump services99192 Special pump services99356 "Prolonged service, inpatient"99357 "Prolonged service, inpatient"Go to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 31

Addendum E.-HCPCS Codes That Are Paid Only as Inpatient Procedures for CY 201099462 "Sbsq nb em per day, hosp"99468 "Neonate crit care, initial"99469 "Neonate crit care, subsq"99471 "Ped critical care, initial"99472 "Ped critical care, subsq"99475 "Ped crit care age 2-5, init"99476 "Ped crit care age 2-5, subsq"99477 Init day hosp neonate care99478 "Ic, lbw inf < 1500 gm subsq"99479 Ic lbw inf 1500-2500 g subsq99480 Ic inf pbw 2501-5000 g subsq0048T Implant ventricular device0050T Removal circulation assist0051T Implant total heart system0052T Replace component heart syst0053T Replace component heart syst0075T Perq stent/chest vert art0076T S&i stent/chest vert art0078T Endovasc aort repr w/device0079T Endovasc visc extnsn repr0080T Endovasc aort repr rad s&i0081T Endovasc visc extnsn s&i0092T Artific disc addl C0095T Artific diskectomy addl0098T Rev artific disc addl0157T Open impl gast curve electrd0158T Open remv gast curve electrd0163T Lumb artif diskectomy addl0164T Remove lumb artif disc addl0165T Revise lumb artif disc addl0166T Tcath vsd close w/o bypass0167T Tcath vsd close w bypass0169T Place stereo cath brain0184T Exc rectal tumor endoscopic0195T Arthrod presac interbody0196T Arthrod presac interbody eac0202T Post vert arthrplst 1 lumbar0219T Fuse spine facet jt cerv0220T Fuse spine facet jt thorG0341 Percutaneous islet celltransG0342 Laparoscopy islet cell transG0343 Laparotomy islet cell transpG0406 Telhealth inpt consult 15minG0407 Telheath inpt consult 25minG0408 Telhealth inpt consult 35minsG0412 Open tx iliac spine uni/bilG0414 Pelvic ring fx treat int fixG0415 Open tx post pelvic fxctureG0425 Inpt telehealth consult 30mG0426 Inpt telehealth consult 50mG0427 Inpt telehealth con 70/>mGo to the CMS website, www.cms.hhs.gov, for the official Addendum E. Page 32