13150 Repair of wound - complex - 0-1cm eyes ears nose lips Page 2

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1 CPT Codes CPTList Code Description Fee Acne Surgery (opening of multiple cyst, comedones...) Incision and drainage (I&D) of skin abscess (hidradenitis, cyst, furuncle, paronychia) - simple or single Incision and drainage (I&D) of skin abscess (hidradenitis, cyst, furuncle, paronychia) - complex or multiple Incision and drainage (I&D) of pilonidal cyst; simple Incision and drainage (I&D) of pilonidal cyst; complex Incision and removal of foreign body, subcutaneous; simple Incision and removal of foreign body, subcutaneous; complex Incision and drainage (I&D) of hematoma or seroma Puncture aspiration of abscess, hematoma, seroma Incision and drainage (I&D) complex post-op infection Debridement skin partial thickness for ecaema <10% Debridement skin partial thickness for ecaema >10% Debridement Necrotizing Fascitis perineum/genitalia Debridement Necrotizing Fascitis abdominal wall (with or without closure) Debridement Necrotizing Fascitis abdominal wall (with or without closure) and perineum/genitalia Removal of prosthetic mesh associated with necrotizing fascitis of the abdominal wall Debridement Associated with fracture; Skin/subcutaneous tissue Debridement Associated with fracture; Skin/subcutaneous tissue/muscle Debridement Associated with fracture; Skin/subcutaneous tissue/muscle/bone Debridement skin partial thickness Debridement skin full thickness Debridement skin and subcutaneous tissue Debridement skin and subcutaneous tissue and muscle Debridement skin and subcutaneous tissue, muscle, & bone Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); single lesion Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); two to four lesions Paring or cutting of benign hyperkeratotic lesion (eg, corn or callus); more than four lesions Biopsy of skin lesion (includes simple closure) Biopsy of additional skin lesion Excision of skin tags up to Excision of additional skin tags for each additional Excision of benign skin lesion to the trunk/arms/legs <0.5cm² (include scar revision - consider complex repair) Excision of benign skin lesion to the trunk/arms/legs cm² Excision of benign skin lesion to the trunk/arms/legs cm² Excision of benign skin lesion to the trunk/arms/legs cm² Excision of benign skin lesion to the trunk/arms/legs cm² Excision of benign skin lesion to the trunk/arms/legs >4.0cm² 300 Excision of benign skin lesion to the scalp hands feet genitalia neck <0.5cm² benign (include scar revision - consider complex repair) Excision of benign skin lesion to the scalp hands feet genitalia neck cm² benign Excision of benign skin lesion to the scalp hands feet genitalia neck cm² benign Excision of benign skin lesion to the scalp hands feet genitalia neck cm² benign Excision of benign skin lesion to the scalp hands feet genitalia neck cm² benign Excision of benign skin lesion to the scalp hands feet genitalia neck >4.0cm² benign 400 Excision of benign skin lesion to the benign face ears eyes nose lips mucosa <0.5cm² benign (include scar revision consider complex repair) Excision of benign skin lesion to the face ears eyes nose lips mucosa cm² benign Excision of benign skin lesion to the face ears eyes nose lips mucosa cm² benign Excision of benign skin lesion to the face ears eyes nose lips mucosa cm² benign Excision of benign skin lesion to the face ears eyes nose lips mucosa cm² benign Excision of benign skin lesion to the face ears eyes nose lips mucosa >4.0cm² benign Excision of hidradenitis axillary simple Excision of hidradenitis axillary complex repair Excision of hidradenitis inguinal simple Excision of hidradenitis inguinal complex repair Excision of hidradinitis perianal, umbilical, perineal simple Excision of hidradinitis perianal, umbilical, perineal complex Excision of malignant skin lesion; trunk arms legs <0.5cm² Excision of malignant skin lesion; trunk arms legs cm² Excision of malignant skin lesion; trunk arms legs cm² Excision of malignant skin lesion; malignant trunk arms legs cm² Excision of malignant skin lesion; malignant trunk arms legs cm² Excision of malignant skin lesion; malignant trunk arms legs >4.0cm² Excision of malignant skin lesion; scalp hands feet genitalia neck <0.5cm² malignant Excision of malignant skin lesion; scalp hands feet genitalia neck cm² malignant Excision of malignant skin lesion; scalp hands feet genitalia neck cm² malignant Excision of malignant skin lesion; scalp hands feet genitalia neck cm² malignant Excision of malignant skin lesion; scalp hands feet genitalia neck cm² malignant Excision of malignant skin lesion; scalp hands feet genitalia Page neck 1 >4.0cm² malignant 800

2 11640 Excision of malignant skin lesion; face ears eyes nose CPTList lips mucosa <0.5cm² malignant Excision of malignant skin lesion; face ears eyes nose lips mucosa cm² malignant Excision of malignant skin lesion; face ears eyes nose lips mucosa cm² malignant Excision of malignant skin lesion; face ears eyes nose lips mucosa cm² malignant Excision of malignant skin lesion; face ears eyes nose lips mucosa cm² malignant Excision of malignant skin lesion; face ears eyes nose lips mucosa >4.0cm² malignant Evacuation of subungual hematoma Removal of nail and matrix - partial or complete (eg. ingrown deformed); nail ablation Removal of nail and matrix - partial or complete (eg. ingrown deformed); nail ablation with tip amputation Biopsy of the nail unit Repair of nail bed Reconstruction of nail bed with graft Wedge excision of nail fold (ingrown nail) Excision of pilonidal cyst Excision of pilonidal cyst extensive Excision of pilonidal cyst complicated Tattooing - up to 6.0 cm² Tattooing - up to cm² Tattooing - each additional 20.0 cm² Subcutaneous injection of collagen; 1cc or less Subcutaneous injection of collagen; cc Subcutaneous injection of collagen; cc Subcutaneous injection of collagen; >10.0 cc Insertion of tissue expander for other than breast reconstruction Replace expander with permanent prothesis (includes exchange for breast reconstruction) Removal tissue expander without insertion Simple repair of wound(s) except face <2.5 cm Simple repair of wound(s) except face cm Simple repair of wound(s) cm except face Simple repair of wound(s) cm except face Simple repair of wound(s) cm except face Simple repair of wound(s) >30cm except face Simple repair of wound(s) face <2.5 cm Simple repair of wound(s) cm face Simple repair of wound(s) cm face Simple repair of wound(s) cm face Simple repair of wound(s) cm face Simple repair of wound(s) cm face Simple repair of wound(s) >30cm face Treatment of superficial wound dehiscence - simple closure Treatment of superficial wound dehiscence - treated with packing Layered closure of wound(s) - intermediate - scalp trunk ext. <2.5cm Layered closure of wound(s) - intermediate - scalp trunk ext cm Layered closure of wound(s) - intermediate - scalp trunk ext cm Layered closure of wound(s) - intermediate - scalp trunk ext cm Layered closure of wound(s) - intermediate - scalp trunk ext cm Layered closure of wound(s) - intermediate - scalp trunk ext. >30cm Layered closure of wound(s) - intermediate - <2.5cm neck hands feet genitals Layered closure of wound(s) - intermediate cm neck hands feet genitals Layered closure of wound(s) - intermediate cm neck hands feet genitals Layered closure of wound(s) - intermediate cm neck hands feet genitals Layered closure of wound(s) - intermediate cm neck hands feet genitals Layered closure of wound(s) - intermediate - >30cm neck hands feet genitals Layered closure of wound(s) - intermediate - <2.5cm face ears eyes nose lips Layered closure of wound(s) - intermediate cm face ears eyes nose lips Layered closure of wound(s) - intermediate cm face ears eyes nose lips Layered closure of wound(s) - intermediate cm face ears eyes nose lips Layered closure of wound(s) - intermediate cm face ears eyes nose lips Layered closure of wound(s) - intermediate cm face ears eyes nose lips Layered closure of wound(s) - intermediate - >30cm face ears eyes nose lips Repair of wound - complex - trunk cm Repair of wound - complex - trunk cm Repair of wound - complex - trunk; each additional 5 cm to Repair of wound - complex - scalp arms legs cm Repair of wound - complex - scalp arms legs cm Repair of wound - complex - scalp arms legs; each additional 5 cm to Repair of wound - complex cm; face (forehead/cheeks/chin/mouth), neck, ax., hands, feet, genitals Repair of wound - complex cm; face (forehead/cheeks/chin/mouth), neck, ax., hands, feet, genitals 750 Repair of wound - complex - face (forehead/cheeks/chin/mouth), neck, ax., hands, feet, genitals; each additional cm to Repair of wound - complex - 0-1cm eyes ears nose lips Page 2 500

3 13151 Repair of wound - complex cm eyes ears nose CPTList lips Repair of wound - complex cm eyes ears nose lips Repair of wound - complex - eyes ears nose lips; each additional 5 cm to Secondary closure of surgical wound or dehiscence - complex ******NO LONGER VALID - DELETED 2000 Repair of wound - complex - >7.5cm² Skin tissue rearrangement - to 10cm² - trunk Skin tissue rearrangement - to 10-30cm² - trunk Skin tissue rearrangement - to 10cm² - scalp arms legs Skin tissue rearrangement - to 10-30cm² - scalp arms legs Skin tissue rearrangement - to 10cm² - face hands ax genitals feet Skin tissue rearrangement - to 10-30cm² - face hands ax genitalia feet Skin tissue rearrangement - to 10cm² - eye, nose ear lip Skin tissue rearrangement - to 10-30cm² - eye, nose ear lip (for full thickness eye - see 67961) Skin tissue rearrangement - unusual or > 30cm² (code includes lesion excision and add flap and defect for size) Toe or finger filet flap!changed'99! Surg prep or creation of recipient site by excision of wound or eschar (not just for burns osteomyelitis); 1st 100 cm² (soft tissue debridement) 750 Surg prep or creation of recipient site by excision of wound or eschar; each add. 100 cm² (not just for burns osteomyelitis)(soft tissue debridement) Harvest of skin for cultured skin autograft Pinch skin graft up to 2 cm² Split thickness skin graft (STSG) to 100cm² (or 1% TBSA in kids) trunk arms legs Split thickness skin graft (STSG) each additional 100cm² Epidermal autograft (autologous epidermis thin STSG) trunk/arms/legs; 1st 100 cm² Epidermal autograft (autologous epidermis thin STSG) trunk/arms/legs; each add 100 cm² Epidermal autograft (autologous epidermis thin STSG) all else (face/hands/feet ); 1st 100 cm² Epidermal autograft (autologous epidermis thin STSG) all else (face/hands/feet ); each add 100 cm² Split thickness skin graft (STSG) to 100cm² face eyes mouth ears genitals multiple digits Split thickness skin graft (STSG) each additional 100cm² Dermal autograft (autologous autogenous dermis graft) trunk/arms/legs; 1st 100 cm² Dermal autograft (autologous autogenous dermis graft) trunk/arms/legs; each add 100 cm² Dermal autograft (autologous autogenous dermis graft) all else (face/hands/feet ); 1st 100 cm² Dermal autograft (autologous autogenous dermis graft) all else (face/hands/feet ); each add 100 cm² Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; 1st 25 cm² Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; each add 25 cm² to Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; each add 100 cm² Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; 1st 25 cm² Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; each add 25 cm² to Tissue cultured epidermal autograft (CEA, Epicel, Epidex) trunk/arms/legs; each add 100 cm² Tissue derived or manufactured "neodermis" (Integra) trunk/arms/legs; 1st 100 cm² Tissue derived or manufactured "neodermis" (Integra) trunk/arms/legs; each add 100 cm² Tissue derived or manufactured "neodermis" (Integra) all else (face/hands/feet ); 1st 100 cm² Tissue derived or manufactured "neodermis" (Integra) all else (face/hands/feet ); each add 100 cm² Full thickness skin graft (FTSG) to 20cm² trunk: closure included Full thickness skin graft (FTSG) each additional 20cm² to Full thickness skin graft (FTSG) to 20cm² scalp arms legs: closure included Full thickness skin graft (FTSG) each additional 20cm² to Full thickness skin graft (FTSG) to 20cm² face, genitals, axil., hands, feet: closure included Full thickness skin graft (FTSG) each additional 20cm² to Full thickness skin graft (FTSG) to 20cm² nose ears eyes: closure included Full thickness skin graft (FTSG) each additional 20cm² to Allograft for temporary wound closure (cadaveric skin non-autologous human skin homograft) trunk/arms/legs; 1st cm² Allograft for temporary wound closure (cadaveric skin non-autologous human skin homograft) Allograft for temporary wound closure (cadaveric skin non-autologous human skin homograft) Allograft for temporary wound closure (cadaveric skin non-autologous human skin homograft) Acellular dermal allograft (allogenic dermis Alloderm) trunk/arms/legs; 1st 100 cm² Acellular dermal allograft (allogenic dermis Alloderm) trunk/arms/legs; each add 100 cm² Acellular dermal allograft (allogenic dermis Alloderm) all else (face/hands/feet ); 1st 100 cm² Acellular dermal allograft (allogenic dermis Alloderm) all else (face/hands/feet ); each add 100 cm² Tissue cultured ALLOgenic skin substitute (contains both dermis and epi Apligraf) trunk/arms/legs; 1st 25 cm² Tissue cultured ALLOgenic skin substitute (contains both dermis and epi Apligraf) trunk/arms/legs; each add 25 cm² Application of allograft (cadaver skin/allograft/alloderm); 1st 100 cm² Application of allograft (cadaver skin/allograft/alloderm); each additional 100 cm² Tissue cultured ALLOgenic dermal substitute (Transcyte Dermagraft) trunk/arms/legs; 1st 100 cm² Tissue cultured ALLOgenic dermal substitute (Transcyte Dermagraft) trunk/arms/legs; each add 100 cm² Tissue cultured ALLOgenic dermal substitute (Transcyte Dermagraft) all else (face/hands/feet ); 1st 100 cm² Tissue cultured ALLOgenic dermal substitute (Transcyte Dermagraft) all else (face/hands/feet ); each add 100 cm² Application of Xenograft (pigskin EZ Derm Mediskin) trunk/arms/legs (not hands/feet; see 420); 1st 100 cm² Page 3

4 Application of Xenograft (pigskin EZ Derm Mediskin) trunk/arms/legs CPTList (not hands/feet; see 420); each add 100 cm² additional Application of Xenograft (pigskin EZ Derm Mediskin) all else (face, hands ); 1st 100 cm² Application of Xenograft (pigskin EZ Derm Mediskin) all else (face, hands ); each add. 100 cm² Formation of direct or tubed pedicle, with or without transfer; trunk Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs 1000 Formation of direct or tubed pedicle, with or without transfer; cross finger flap, face, hands, feet, neck, axilla, genitalia (groin flap)(code skin graft sep.) Formation of direct or tubed pedicle, with or without transfer; eyes, ears, nose, lips, or mucosa Delay or sectioning of flap (divisionand inset); trunk Delay or sectioning of flap (divisionand inset); scalp, arms, or legs Delay or sectioning of flap (divisionand inset); forehead, cheek, neck, axillae, genitalia, hands (cross finger), or feet ******No longer valid ********* use Delay or sectioning of flap (divisionand inset); crossfinger Delay or sectioning of flap (divisionand inset); eyelids, ears, nose, or lips Transfer, intermediate, of any pedicle flap (walking tube eg) any location Muscle, myocutaneous, or fasciocutaneous flap; head and neck Muscle, myocutaneous, or fasciocutaneous flap; trunk Muscle, myocutaneous, or fasciocutaneous flap; upper extremity Muscle, myocutaneous, or fasciocutaneous flap; lower extremity Flap: island pedicle (any location) Neurovascular pedicle island flap DELETED FOR Free flap (15845 for CN VII muscle free flap) Free flap; muscle with or without overlying skin (TRAM, myocutaneous...) Free flap; skin (radial forearm or scapular with skin) Free flap; fascial (TPL...) Composite graft; including ala and ear Composite graft; including dermal/fat/fascia Hair transplant punch grafts; 1 to Hair transplant punch grafts; more than 15 (for strip grafts, use 15220) Dermabrasion total face Dermabrasion segmantal face Dermabrasion other than face Dermabrasion; superficial (tattoo...) Dermabrasion; single lesion (eg keratosis or scar) Dermabrasion; each addition 4 lesions or less (eg keratosis or scar) Chemical peel of face - epidermal (TCA...) Chemical peel of face - dermal (Phenol) Chemical peel, nonfacial - epidermal (TCA...) Chemical peel, nonfacial - dermal (phenol...) Salabrasion; 20cm² or less Salabrasion; over 20cm² Cervicoplasty Blepharoplasty of lower eyelid Blepharoplasty of lower eyelid; extensive fat Blepharoplasty of upper eyelid Blepharoplasty of upper eyelid with excessive skin or fat weighting down eyelids Rhytidectomy of forehead; browlift (for brow ptosis use 67900) Rhytidectomy of neck with platysmal tightening Rhytidectomy of glabellar frown lines Rhytidectomy of cheek, chin, and neck Rhytidectomy of SMAS (for bilateral use -50 modifier) Abdominoplasty Thigh plasty Excision of excess fat in the leg Excision of excess fat in the hip Excision of excess fat in the buttock Excision of excess fat in the arm (brachioplasty) Excision of excess fat in the forearm and hand Excision of excess fat in the submental fat pad Excision of excess fat in another area Graft (fascia or tendon) for facial nerve palsy (CN VII paralysis) eg. TFL (includes obtaining graft) Graft (muscle non microvascular) for facial nerve palsy (CN VII paralysis) Graft (muscle free flap) for facial nerve palsy (CN VII paralysis) Regional muscle transfer (eg temporalis) for facial nerve palsy (CN VII paralysis) Removal of sutures under anesthesia - same surgeon Removal of sutures under anesthesia - different surgeon Dressing change under anesthesia (other than burns) Fluorescein injection to test flap viability Suction assisted lipectomy; head and neck Suction assisted lipectomy; trunk Page

5 15878 Suction assisted lipectomy; upper extremities CPTList Suction assisted lipectomy; lower extremities Excision of coccygeal pressure ulcer with 1 closure (decubitus sore) Excision of coccygeal pressure ulcer with flap closure (decubitus sore) Excision of sacral pressure ulcer with 1 closure (decubitus sore) Excision of sacral pressure ulcer with ostectomy and 1 closure (decubitus sore) Excision of sacral pressure ulcer with flap closure (decubitus sore) Excision of sacral pressure ulcer with ostectomy and flap closure (decubitus sore) 1500 Excision of sacral pressure ulcer IN PREP FOR myocutaneous flap closure (ID flap with separate code) CHANGED' Excision of sacral pressure ulcer with ostectomy and myocutaneous flap closure (ID flap with separate code) Excision of ischial pressure ulcer with 1 closure (decubitus sore) Excision of ischial pressure ulcer with ostectomy and 1 closure (decubitus sore) Excision of ischial pressure ulcer with flap closure (decubitus sore) Excision of ischial pressure ulcer with myocutaneous flap closure (ID flap with separate code) 2000 Excision of ischial pressure ulcer IN PREP FOR myocutaneous flap closure (ID flap with separate code) CHANGED' Excision of trochanteric pressure ulcer with 1 closure (decubitus sore) Excision of trochanteric pressure ulcer with ostectomy and 1 closure (decubitus sore) Excision of trochanteric pressure ulcer with flap closure (decubitus sore) Excision of trochanteric pressure ulcer with flap closure (decubitus sore) 1800 Excision of trochanteric pressure ulcer IN PREP FOR myocutaneous flap closure (ID flap with separate code) CHANGED' Excision of trochanteric pressure ulcer with ostectomy and myocutaneous flap closure (ID flap with separate code) Excision of pressure ulcer (decubitus sore) other Debridement of small burn under anesthesia Debridement of large burn under anesthesia Debridement of small burn no anesthesia Debridement of medium burn under anesthesia Debridement of large burn under anesthesia Escharotomy Destruction benign/premalignant by any means: first lesion Destruction benign/premalignant by any means: 2-14 lesions Destruction benign/premalignant by any means: 15 or more lesions Destruction of cutaneous vascular proliferative lesions (laser...) less than 10cm² Destruction of cutaneous vascular proliferative lesions (laser...) 10cm² to 50cm² Destruction of cutaneous vascular proliferative lesions (laser...) greater than 50cm² Destruction of warts up to Destruction of warts 15 or more Chemical cauterization of granulation tissue (Silver nitrate) Mohs' chemosurgery; 1st stage up to 5 specimens Mohs' chemosurgery; 2nd stage up to 5 specimens Mohs' chemosurgery; 3rd stage up to 5 specimens Mohs' chemosurgery; additional stages beyond 3 up to 5 specimens Mohs' chemosurgery; any stage more than 5 specimens Chemical exfoliation for acne Tissue grafts - other (use for Platelet rich graft, plt - document need in op note) Puncture aspiration of cyst of breast; first Puncture aspiration of cyst of breast; each additional Mastotomy with exploration or drainage of abscess, deep Injection procedure for ductogram Breast biopsy; Tru-cut needle (for fine needle aspiration, use 88170) Biopsy of breast; incisional Nipple exploration with or without excision of duct Excision of lactiferous duct fistula Excision of breast tumor; benign or malignant, ectopic, supernumery, axillary Excision of breast lesion identified by wire (needle localization biopsy); single Excision of breast lesion identified by wire (needle localization biopsy); each additional Mastectomy for gynecomastia Partial mastectomy Partial mastectomy with axillary lymphadenectomy Mastectomy, simple, complete (+/- prophylactic) Mastectomy, subcutaneous (+/- prophylactic) Radical mastectomy Modified radical mastectomy with axillary lymphadenectomy Excision of chest wall tumor including ribs Excision of chest wall tumor including ribs with plastic reconstruction; without lymphadenectomy Excision of chest wall tumor including ribs with plastic reconstruction; with lymphadenectomy Mastopexy Breast reduction (use -50 modifier for bilateral) Breast augmentation mammaplasty without implant Page

6 19325 Breast augmentation mammaplasty with implant CPTList Removal of intact mammary implant Removal of implant material (broken implant) Immediate breast reconstruction with implant Delayed breast reconstruction with implant Nipple - areola reconstruction (includes flaps and FTSG) Correction of inverted nipples Breast reconstruction (immediate or delayed) with tissue expander (including expansion) (see for exchange) Breast reconstruction with latissimus dorsi flap with or without implant Breast reconstruction with free flap (NOW ALL INCLUSIVE (shaping, flap, vessels...) CHANGED' Breast reconstruction with other technique Unipedical TRAM including donor closure (transverse) Supercharged TRAM (transverse) Bipedical TRAM (transverse) Open periprosthetic capsulotomy Periprosthetic capsulectomy Revision of reconstructed breast Preparation of moulage for custom implant Incision of soft tissue abscess; superficial (I&D) Incision of soft tissue abscess; deep or complicated Exploration of penetrating neck trauma Exploration of penetrating chest wound Exploration of penetrating trunk wound Exploration of penetrating extremity wound Biopsy, muscle, superficial Biopsy, muscle, deep Biopsy, bone; superficial with trocar or needle (sacrum, sternum, ribs...) Biopsy, bone; deep with trocar or needle (femur, humerus...) Biopsy, bone; superficial excisional (sacrum, sternum, ribs...) Biopsy, bone; deep excisional (femur, humerus...) Removal of foreign body in muscle or tendon sheath - simple Removal of foreign body in muscle or tendon sheath - complex Injection of trigger points, trigger fingers, ligaments (tennis elbow), ganglion cysts, tendon sheath, steroid Arthrocentesis, aspiration and/or injection small joint, bursa or ganglion cyst (eg. finger or toes), steroid Insertion of wire or pin with application of skeletal traction, in cluding removal (separate procedure) Removal pin or wire - buried but superficial Removal pin or plate - deep (sternal wire) Adjustment or revision of external fixation system requiring anesthesia (eg. new pins...) Removal of external fixation device under anesthesia Replantation of arm at the level of the humerus; complete amputation Replantation of arm at the level of the humerus; incomplete amputation Replantation of forearm at the level of the radius/ulna; complete amputation (incomplete report each repair) Replantation of the hand at wrist; complete (if incomplete, report individual structure repair - tendon, bone...) Replantation of a digit - except thumb MCP to insertion of sublimus tendon; complete (incomplete report each repair) 2800 Replantation of a digit - except thumb distal to insertion of sublimus tendon; complete (incomplete report each repair) Replantation thumb - CMC to MCP; complete (incomplete report each repair) Replantation thumb - distal to MCP; complete (incomplete report each repair - tendon, bone...) Replantation foot; complete ( have been deleted - report individual repairs instead of replant) Removal of bone graft for any small area Removal of bone graft for major or large Removal of cartilage graft; rib (microtia reconstruction) Removal of cartilage graft; nasal septum Removal of fascia lata graft (TFL) with stripper (eg. for CN VII) Removal of fascia lata graft (TFL) with incision (eg. for CN VII) Removal of tendon graft from a distance Removal of other tissue graft (dermal fat graft, paratenon, dermis) - (use for Platelet rich harvest - plt) Insertion and monitoring of compartment pressures Free bone flap; fibula (free flap) Bone free flap; iliac crest Bone free flap; metatarsal Bone free flap; other - DELETED FOR use Bone free flap; other Osteocutaneous free flap; other Osteocutaneous free flap; iliac crest Osteocutaneous free flap; rib - DELETED FOR use Osteocutaneous free flap; metatarsal Osteocutaneous free flap; Great toe with web space Radical resection of tumor (eg. malignant neoplasm), soft tissue of face or scalp Excision/debridement of bone (eg. for osteomyelitis); mandible 1200 Page 6

7 CPTList Excision/debridement of bone (eg. for osteomyelitis); facial bones Removal by contouring of facial bone (eg. fibrous dysplasia) Excision of benign tumor of facial bone other than mandible Excision of torus mandibularis (exostosis) Excision of torus platinus of the maxilla Excision of malignant tumor of facial bone other than the mandible Excision of benign cyst or tumor of the mandible Excision of benign cyst or tumor of the mandible; complex Excision of malignant tumor of the mandible Radical excision of tumor of the mandible Condylectomy, TMJ Meniscectomy, partial or complete TMJ Coronoidectomy Apply halo appliance for maxillofacial fixation IMF for other than trauma TMJ injection for arthrogram Genioplasty with implant; autograft, allograft, prosthetic Genioplasty sliding osteotomy - single piece Genioplasty sliding osteotomy - multiple pieces for asymmetry Genioplasty sliding osteotomy with interpositional bone graft Augmentation of mandible body or angle with prosthesis Augmentation of mandible with bone Reduction of forehead; contuoring only Reduction of forehead; contuoring and graft Reduction of forehead; with set back Reconstruction of the midface, LeFort I; single piece without bone (eg. for long face) Reconstruction of the midface, LeFort I; two pieces without bone (eg. for long face) Reconstruction of the midface, LeFort I; three or more pieces without bone (eg. for long face) Reconstruction of the midface, LeFort I; single piece with bone (eg. for long face) Reconstruction of the midface, LeFort I; two pieces with bone (eg. for long face) Reconstruction of the midface, LeFort I; three or more pieces with bone (eg. for long face) Reconstruction of the midface, LeFort II; single piece without bone (eg. anterior intrusion Treacher-Collins) Reconstruction of the midface, LeFort II; above with bone graft Reconstruction of the midface, LeFort III; with bone and without LeFort I Reconstruction of the midface, LeFort III; with LeFort I Reconstruction of the midface, LeFort III; frontalorbital advance (mono bloc) without LeFort I Reconstruction of the midface, LeFort III; frontalorbital advance (mono bloc) with LeFort I Fronto-orbital advancement with or without bone grafts (includes getting grafts) (for craniotomy 61556) Fronto-orbital advancement (as above, but bifrontal) Reconstruct entire or majority of forehead with allograft or implants Reconstruct entire or majority of forehead with autograft (includes getting graft) Reconstruction by contouring of benign tumor of cranial bones (eg. fibrous dysplasia) Reconstruct cranial bone after extripation of benign tumor - <40cm² bone graft Reconstruct cranial bone after extripation of benign tumor cm² bone graft Reconstruct cranial bone after extripation of benign tumor - >800cm² bone graft Reconstruction of midface with osteotomies other than LeFort's Reconstruction of mandibular rami, horizontal, vertical, "C", "L", osteotomy; without bone graft Reconstruction of mandibular rami, horizontal, vertical, "C", "L", osteotomy; with bone graft (includes getting) Reconstruction of mandibular rami/body sagittal split; without internal rigid fixation Reconstruction of mandibular rami/body sagittal split; with internal rigid fixation Mandibular osteotomies; segmental Maxillary osteotomies; Wassmund or Schuchard Osteoplasty, facial bones; augmentation (auto, allo, prosth) Reduction of facial bones Bone graft to the nose, maxilla, and/or malar bone graft (non-cleft) (includes obtaining the graft) Bone graft to the mandible (includes obtaining the graft) Rib cartilage graft to the nose, chin, face, ear (includes obtaining the graft) Ear cartilage graft to nose (includes harvest) Arthroplasty TMJ with or without autograft (includes getting graft) Arthroplasty TMJ with allograft Arthroplasty TMJ with prosthesis Reconstruction of mandible with bone plate Reconstruction of mandible with subperiosteal implant; partial Reconstruction of mandible with subperiosteal implant; complete Reconstruction of mandible - condyle with graft Reconstruction of maxilla with endosteal implant; partial Reconstruction of maxilla with endosteal implant; complete Reconstruction of Zygoma with bone graft (includes getting) Reconstruction of orbit with osteotomies and bone graft (eg. micro-ophthalmia) Periorbital osteotomies for hypertelorism extracranial approach with bone graft Periorbital osteotomies for hypertelorism extracranial and intracranial approach with bone graft Page 7

8 21263 Periorbital osteotomies for hypertelorism extracranial CPTList approach with bone graft with forehead advance Orbital repositioning with bone graft; unilateral extracranial Orbital repositioning with bone graft; unilateral extracranial and intracranial Malar augmentation with prosthesis (with bone see 21210) Secondary revision of orbitalcranialfacial reconstruction Medial canthopexy (for canthoplasty see 67950) Lateral canthopexy Revision of masseter muscle and bone (eg. for benign masseteric hypertrophy); extraoral approach Revision of masseter muscle and bone (eg. for benign masseteric hypertrophy); intraoral approach Other unlisted craniofacial procedure Closed treatment of skull fracture Treatment of nasal fracture without manipulation Closed treatment of nasal fracture without splint Closed treatment of nasal fracture with splint Open treatment of nasal fracture - uncomplicated Open treatment of nasal fracture - complicated with internal/external fixation (ORIF nose) Open treatment of nasal fracture - above with septum Open treatment of nasal septal fracture with or without stabilzation Closed treatment of nasal septal fracture with or without stabilzation Open treatment of nasoethmoidal (NOE) fracture without external fixation Open treatment of nasoethmoidal (NOE) fracture with external fixation Percutaneous treatment of NOE including canthal ligament repair and/or nasolacrimal apparatus Open treatment of depressed frontal sinus fracture Open treatment of depressed frontal sinus fracture - complex (posterior wall, comminuted, mult. approach) Closed treatment of LeFort II (nasomaxillary fracture) with IMF Open treatment (ORIF) of LeFort II (nasomaxillary fracture) with IMF and wire or plates Open treatment of LeFort II (ORIF) (nasomaxillary fracture) with IMF and wire or plates from multiple approaches Open treatment of LeFort II (ORIF) (nasomaxillary fracture) with bone graft Percutaneous treatment of Zygomatic arch with manipulation Open treatment of Zygomatic arch (eg Gilles approach) Open treatment of Zygomatic arch or tripod (ZMC complex) Open treatment (ORIF) of Zygomatic arch or tripod (ZMC complex) - complex Open treatment (ORIF) of Zygomatic arch or tripod (ZMC complex) - complex with bone graft (includes getting bone) Open treatment of orbital blowout fracture (floor) transantral approach Open treatment of orbital blowout fracture (floor) periorbital approach Open treatment of orbital blowout fracture (floor) combined approach Open treatment of orbital blowout fracture (floor) periorbital approach with alloplastic implant Open treatment of orbital blowout fracture (floor) periorbital approach with bone graft Closed treatment of orbital fracture (non-blowout) - no manipulation Closed treatment of orbital fracture (non-blowout) - with manipulation Open treatment of orbital fracture (non-blowout) Closed treatment of orbital fracture (non-blowout) with implant Closed treatment of orbital fracture (non-blowout) with bone graft Closed treatment of maxillary fracture - LeFort I with IMF alone Open treatment of maxillary fracture - LeFort I Open treatment of maxillary fracture - LeFort I - complex with multiple approaches Closed treatment of Craniofacial dissocation fracture (LeFort III) with IMF alone Open treatment of Craniofacial dissocation fracture (LeFort III) with IMF or plates (ORIF) Open treatment of Craniofacial dissocation fracture (LeFort III) with IMF or plates (ORIF) and multiple approaches Open treatment of Craniofacial dissocation fracture (LeFort III) - above with external fixation as well Open treatment of Craniofacial dissocation fracture (LeFort III) with IMF or plates (ORIF) with bone graft Closed treatment of mandibular or maxillary alveolar ridge fracture Open treatment of mandibular or maxillary alveolar ridge fracture Closed treatment of mandibular fracture without manipulation Closed treatment of mandibular fracture with manipulation Closed treatment of mandibular fracture with manipulation with external fixation Closed treatment of mandibular fracture with manipulation with IMF Open treatment of mandibular fracture with manipulation with external fixation Open treatment of mandibular fracture with manipulation without IMF Open treatment of mandibular fracture with manipulation with IMF Open treatment of mandibular condyle fracture Open treatment of mandibular condyle fracture - complex ORIF Closed treatment of TMJ dislocation Closed treatment of TMJ dislocation - complicated requiring IMF Open treatment of TMJ dislocation Closed treatment of Hyoid fracture Closed treatment of Hyoid fracture - with manipulation Open treatment of Hyoid fracture IMF for condition other than fracture Unlisted musculoskeletal procedure of the head - otherpage 8

9 21600 Rib resection, partial CPTList Sternal debridement - partial (eg for osteomyelitis or dehisence) Sternal debridement (eg for osteomyelitis or dehisence) Radical sternectomy (eg for osteomyelitis or dehisence) Radical sternectomy with lymphadenectomy Division of scalenus anticus; without resection of cervical rib Division of scalenus anticus; with resection of cervical rib Division of sternocleidomastoid for torticollis without cast application Division of sternocleidomastoid for torticollis with cast application Reconstruction of pectus excavatum or carinatum Closure of sternotomy separation with or without debradement Debridement of vertebral spinous process, single vertebral segment; cervical (osteomyelitis) Debridement of vertebral spinous process, single vertebral segment; thoracic (osteomyelitis) Debridement of vertebral spinous process, single vertebral segment; lumbar (osteomyelitis) Debridement of clavicle for osteomyelitis Debridement of scapula for osteomyelitis Debridement of humerus, proximal for osteomyelitis Debridement of humerus, shaft or distal for osteomyelitis Debridement of radial head or neck for osteomyelitis Debridement of olecranon for osteomyelitis Repair of tendon/muscle of the arm or elbow Repair or reinsertion of biceps or triceps tendon Lateral or medial fasciotomy of elbow (tennis elbow) Lateral or medial fasciotomy of elbow (tennis elbow) plus detachment of ext origin Lateral or medial fasciotomy of elbow (tennis elbow) plus resection of annular ligment Lateral or medial fasciotomy of elbow (tennis elbow) plus stripping Lateral or medial fasciotomy of elbow (tennis elbow) plus partial ostectomy (epicondylectomy) Decompression fasciotomy, forearm, with brachial arter exploration Open treatment radial head or neck fracture Above with implant Closed treatment of ulnar fracture proximal without manipulation Closed treatment of ulnar fracture proximal with manipulation Open treatment of ulnar fracture proximal with or without ex fix Tendon sheath incision, at radial styloid (dequervain's disease, tendonitis, FCR) Decompression fasciotomy, forearm and/or wrist; flexor or extensor compartment Decompression fasciotomy, forearm and/or wrist; above with muscle debridement Incision and drainage I&D forearm and/or wrist deep hematoma or abscess Incision and drainage I&D forearm and/or wrist deep infected bursa Incision and drainage I&D forearm and/or wrist of bone; osteomyelitis Exploration of radiocarpal joint (arthrotomy) with removal of foreign body Superficial biopsy of forearm soft tissue Deep biopsy of forearm soft tissue Subcutaneous excision of forearm/wrist tumor Deep excision of forearm/wrist tumor Radical excision of forearm/wrist tumor Capsulotomy of wrist for contracture Biopsy of wrist joint Exploration of wrist joint (arthrotomy) with removal of foreign body Exploration of wrist joint (arthrotomy) for synovectomy Exploration of wrist joint (arthrotomy) for TFCC repair (triangular) Excision of lesion of tendon sheath, forearm and/or wrist Excision of ganglion; wrist Excision of recurrent ganglion wrist Radical synovectomy of wrist flexors Radical synovectomy of wrist extensors Synovectomy of extensor tendon sheath, wrist, single compartment Synovectomy of extensor tendon sheath, wrist, single compartment with excision distal ulna Removal bone cyst (excision or curettage) of distal radius or ulna Removal bone cyst (excision or curettage) of distal radius or ulna with AUTOGRAFT reconstruction Removal bone cyst (excision or curettage) of distal radius or ulna with ALLOGRAFT reconstruction Removal bone tumor (excision or curettage) carpal bones Removal bone tumor (excision or curettage) carpal bones with AUTOGRAFT reconstruction Removal bone tumor (excision or curettage) carpal bones with ALLOGRAFT reconstruction Sequestrectomy forearm or wrist (eg. for osteomyelitis) Partial excision of ulnal for osteomyelitis Partial excision of radius for osteomyelitis Radical resection for cancer or tumor of radius or ulna Carpectomy (one bone) (eg. for osteomyelitis) Proximal row carpectomy Radial styloidectomy Partial resection of distal ulna (Darrach) arthroplasty (for Page implant ; for getting fascia 20920, 20922) 750

10 25246 Injection for arthrogram CPTList Exploration with removal of deep forearm/wrist foreign body Removal of wrist prosthesis Removal of wrist prosthesis; complicated Repair flexor tendon at wrist/forearm Repair flexor tendon at wrist/forearm Repair flexor tendon at wrist/forearm 2 with graft Repair extensor tendon at wrist/forearm Repair extensor tendon at wrist/forearm Repair extensor tendon at wrist/forearm 2 with graft Shorten or lengthen forearm/wrist flexor/extensor tendon; each tendon Tenotomy forearm/wrist flexor/extensor tendon; each tendon Tenolysis forearm/wrist flexor/extensor tendon; each tendon Tenodesis flexors at wrist Tenodesis extensors at wrist Tendon transfer at wrist no graft (flexor or extensor) Tendon transfer at wrist with graft (flexor or extensor) Flexor tendon slide at origin for cerebral palsy or Volkmann's contracture (forearm/wrist) Flexor tendon slide at origin for cerebral palsy or Volkmann's contracture (forearm/wrist) with tendon transfer Repair or revise wrist including synovectomy/capsulodesis, ligament repair, tendon interpo... (capsulorrhaphy) Arthroplasty of wrist with/without interposition, with/without int./ext. fixation Centralization of wrist on ulna (eg. radial club hand) Secondary reconstruction of distal ulna/druj by soft tissue stabilization (code harvest separately) Osteotomy, radius; distal third Osteotomy, radius; middle or proximal third Osteotomy, ulna Osteotomy; radius and ulna Multiple osteotomies; radius OR ulna Osteoplasty; radius or ulna; shortening Osteoplasty; radius or ulna; lengthening with autograft Osteoplasty; radius AND ulna; shortening Osteoplasty; radius AND ulna; lengthening with autograft Repair of nonunion or malunion of the radius OR ulna without graft (eg. compression) Repair of nonunion or malunion of the radius OR ulna with bone graft (includes harvest) Repair of nonunion or malunion of the radius AND ulna without graft (eg. compression) Repair of nonunion or malunion of the radius AND ulna with bone graft (includes harvest) Repair of defect with autograft radius OR ulna (includes harvest) Repair of defect with autograft radius AND ulna (includes harvest) Repair of nonunion of the scaphoid with or without radial styloidectomy (includes harvest and fixation) Arthroplasty with prosthetic replacement; distal radius Arthroplasty with prosthetic replacement; distal ulna Arthroplasty with prosthetic replacement; scaphoid Arthroplasty with prosthetic replacement; lunate Arthroplasty with prosthetic replacement; trapezium Total wrist arthroplasty Interposition arthroplasty, IP, MCP, or CMC Revision of arthroplasty, including removal of implant, wrist joint Epiphyseal arrest by epiphysiodesis or stapling; distal radius OR ulna Epiphyseal arrest by epiphysiodesis or stapling; distal radius AND ulna Prophylactic treatment (nailing, pinning plating or wiring with/without MMA; radius Prophylactic treatment (nailing, pinning plating or wiring with/without MMA; ulna Prophylactic treatment (nailing, pinning plating or wiring with/without MMA; radius AND ulna Closed treatment of radial shaft fracture without manipulation Closed treatment of radial shaft fracture with manipulation Open treatment of radial shaft fracture with/without inter/ext fixation Closed treatment of radial shaft fracture sislocation of distal radio-ulnar joint (Galeazzi fx/dislocation) Open treatment of Galeazzi fracture Open treatment of Galeazzi fracture with treatment of TFCC Closed treatment of ulnar shaft fracture without manipulation Closed treatment of ulnar shaft fracture with manipulation Open treatment of ulnar shaft fracture with/without int/ext fixation Closed treatment of radial/ulnar shaft fracture without manipulation Closed treatment of radial/ulnar shaft fracture with manipulation Open treatment of radial and ulnar shaft fracture with/without int/ext fixation on radius OR ulna Open treatment of radial and ulnar shaft fracture with/without int/ext fixation on radius AND ulna Closed treatment of a distal radius and/or ulnar fracture without manipulation Closed treatment of a distal radius and/or ulnar fracture with manipulation (closed reduction) Percutaneous pinning of a distal radius and/or ulnar fracture Open treatment of distal radius and/or ulnar fracture with or without internal or external fixation Closed treatment of a scaphoid fracture without manipulation Closed treatment of a scaphoid fracture with manipulation Page 10