AVAILABLE CPT CODES BY AREA AND TYPE

CYSTOSCOPY CYSTOSCOPY 0084T Insertion of a temporary prostatic urethral stent 50385 Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation 52000 Cystourethroscopy (separate procedure) 52001 Cystourethroscopy with irrigation and evacuation of multiple obstructing clots 52005 Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 52007 Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis 52010 Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service 52204 Cystourethroscopy, with biopsy(s) 52214 Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands 52250 Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration 52260 Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia 52265 Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia 52270 Cystourethroscopy, with internal urethrotomy; female 52275 Cystourethroscopy, with internal urethrotomy; male 52276 Cystourethroscopy with direct vision internal urethrotomy 52277 Cystourethroscopy, with resection of external sphincter (sphincterotomy) 52281 Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female 52282 Cystourethroscopy, with insertion of permanent urethral stent 52283 Cystourethroscopy, with steroid injection into stricture 52285 Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone 52290 Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral 52305 Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple 52310 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple 52315 Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated 52317 Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) 52318 Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) 52332 Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-j type) 52334 Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde 2012 Accreditation Council for Graduate Medical Education (ACGME) 1 9/25/2012 3:34:44PM

CYSTOSCOPY CYSTOSCOPY 52700 Transurethral drainage of prostatic abscess ENDOUROLOGY/STONE DISEASE OTHER (ENDOUROLOGY/STONE DISEASE) 50600 E/SD Ureterotomy with exploration or drainage (separate procedure) 50605 E/SD Ureterotomy for insertion of indwelling stent, all types 50610 E/SD Ureterolithotomy; upper one-third of ureter 50620 E/SD Ureterolithotomy; middle one-third of ureter 50630 E/SD Ureterolithotomy; lower one-third of ureter 50650 E/SD Ureterectomy, with bladder cuff (separate procedure) 50660 E/SD Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach 50945 E/SD/LAP Laparoscopy, surgical; ureterolithotomy OTHER - KIDNEY (ENDOUROLOGY/STONE DISEASE) 50060 E/SD Nephrolithotomy; removal of calculus 50065 E/SD Nephrolithotomy; secondary surgical operation for calculus 50070 E/SD Nephrolithotomy; complicated by congenital kidney abnormality 50075 E/SD Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) 50130 E/SD Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) 50135 E/SD Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) PERCUTANEOUS 50382 E/SD/PER Removal (via snare/capture) and replacement of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation 50384 E/SD/PER Removal (via snare/capture) of internally dwelling ureteral stent via percutaneous approach, including radiological supervision and interpretation 50387 E/SD/PER Removal and replacement of externally accessible transnephric ureteral stent (eg, external/internal stent) requiring fluoroscopic guidance, including radiological supervision and interpretation 50389 E/SD/PER Removal of nephrostomy tube, requiring fluoroscopic guidance (eg, with concurrent indwelling ureteral stent) 50390 E/SD/PER Aspiration and/or injection of renal cyst or pelvis by needle, percutaneous 50391 E/SD/PER Instillation(s) of therapeutic agent into renal pelvis and/or ureter through established nephrostomy, pyelostomy or ureterostomy tube (eg, anticarcinogenic or antifungal agent) 50392 E/SD/PER Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous 2012 Accreditation Council for Graduate Medical Education (ACGME) 2 9/25/2012 3:35:11PM

ENDOUROLOGY/STONE DISEASE PERCUTANEOUS 50393 E/SD/PER Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous 50394 Injection procedure for pyelography (as nephrostogram, pyelostogram, antegrade pyeloureterograms) through nephrostomy or pyelostomy tube, or indwelling ureteral catheter 50395 E/SD/PER Introduction of guide into renal pelvis and/or ureter with dilation to establish nephrostomy tract, percutaneous 50398 E/SD/PER Change of nephrostomy or pyelostomy tube 50551 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 50553 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50555 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy 50557 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50561 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 50562 E/SD/PER Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with resection of tumor 50570 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 50572 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50574 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy 50575 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent) 50576 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50580 E/SD/PER Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 50592 E/SD/PER Ablation, 1 or more renal tumor(s), percutaneous, unilateral, radiofrequency 50593 E/SD/PER Ablation, renal tumor(s), unilateral, percutaneous, cryotherapy PERCUTANEOUS - KIDNEY 50080 E/SD/PER Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm 2012 Accreditation Council for Graduate Medical Education (ACGME) 3 9/25/2012 3:35:11PM

ENDOUROLOGY/STONE DISEASE PERCUTANEOUS - KIDNEY 50081 E/SD/PER Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm SHOCK WAVE LITHOTRIPSY 50590 E/SD/SWL Lithotripsy, extracorporeal shock wave URETEROSCOPY 50951 E/SD/URSCOP Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 50953 E/SD/URSCOP Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50955 E/SD/URSCOP Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy 50957 E/SD/URSCOP Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50961 E/SD/URSCOP Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 50970 E/SD/URSCOP Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 50972 E/SD/URSCOP Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter 50974 E/SD/URSCOP Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy 50976 E/SD/URSCOP Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy 50980 E/SD/URSCOP Ureteral endoscopy through ureterotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus 52320 E/SD/URSCOP Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus 52325 E/SD/URSCOP Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) 52330 E/SD/URSCOP Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus 52341 E/SD/URSCOP Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) 52342 E/SD/URSCOP Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) 2012 Accreditation Council for Graduate Medical Education (ACGME) 4 9/25/2012 3:35:13PM

ENDOUROLOGY/STONE DISEASE URETEROSCOPY 52343 E/SD/URSCOP Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) 52344 E/SD/URSCOP Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) 52345 E/SD/URSCOP Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) 52346 E/SD/URSCOP Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) 52351 E/SD/URSCOP Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic 52352 E/SD/URSCOP Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) 52353 E/SD/URSCOP Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) 52354 E/SD/URSCOP Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion 52355 E/SD/URSCOP Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor GENERAL UROLOGY OTHER (GENERAL UROLOGY) 11420 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less 11421 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm 11422 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm 11423 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm 11424 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm 11426 Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm 11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less 11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm 11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm 11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm 11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm 11626 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm 2012 Accreditation Council for Graduate Medical Education (ACGME) 5 9/25/2012 3:35:13PM

GENERAL UROLOGY OTHER (GENERAL UROLOGY) 12001 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.5 cm or less 12002 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 2.6 cm to 7.5 cm 12004 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 7.6 cm to 12.5 cm 12005 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 12.6 cm to 20.0 cm 12006 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); 20.1 cm to 30.0 cm 12007 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm 12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less 12042 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm 12044 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm 12045 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm 12046 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm 12047 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm 13133 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; each additional 5 cm or less (List separately in addition to code for primary procedure) 13160 Secondary closure of surgical wound or dehiscence, extensive or complicated 14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less 14041 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm 15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children 15005 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure) 15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15116 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15120 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) 2012 Accreditation Council for Graduate Medical Education (ACGME) 6 9/25/2012 3:35:13PM

GENERAL UROLOGY OTHER (GENERAL UROLOGY) 15121 Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15135 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15136 Dermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15155 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 25 sq cm or less 15156 Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; additional 1 sq cm to 75 sq cm (List separately in addition to code for primary procedure) 15175 Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15176 Acellular dermal replacement, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15240 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; 20 sq cm or less 15241 Full thickness graft, free, including direct closure of donor site, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands, and/or feet; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure) 15320 Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15321 Allograft skin for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15335 Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15336 Acellular dermal allograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15365 Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15366 Tissue cultured allogeneic dermal substitute, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 2012 Accreditation Council for Graduate Medical Education (ACGME) 7 9/25/2012 3:35:15PM

GENERAL UROLOGY OTHER (GENERAL UROLOGY) 15420 Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children 15421 Xenograft skin (dermal), for temporary wound closure, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) 15574 Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet 15620 Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet 17270 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less 17271 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm 17272 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm 17273 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 2.1 to 3.0 cm 17274 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 3.1 to 4.0 cm 17276 Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm 17311 Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; first stage, up to 5 tissue blocks 17312 Mohs micrographic technique, including removal of all gross tumor, surgical excision of tissue specimens, mapping, color coding of specimens, microscopic examination of specimens by the surgeon, and histopathologic preparation including routine stain(s) (eg, hematoxylin and eosin, toluidine blue), head, neck, hands, feet, genitalia, or any location with surgery directly involving muscle, cartilage, bone, tendon, major nerves, or vessels; each additional stage after the first stage, up to 5 tissue blocks (List separately in addition to code for primary procedure) 49000 Exploratory laparotomy, exploratory celiotomy with or without biopsy(s) (separate procedure) 49505 GU Repair initial inguinal hernia, age 5 years or older; reducible 49507 GU Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated 49520 GU Repair recurrent inguinal hernia, any age; reducible 49521 GU Repair recurrent inguinal hernia, any age; incarcerated or strangulated 49560 GU Repair initial incisional or ventral hernia; reducible 49561 GU Repair initial incisional or ventral hernia; incarcerated or strangulated 49565 GU Repair recurrent incisional or ventral hernia; reducible 49566 GU Repair recurrent incisional or ventral hernia; incarcerated or strangulated 49587 GU Repair umbilical hernia, age 5 years or older; incarcerated or strangulated 49900 Suture, secondary, of abdominal wall for evisceration or dehiscence 2012 Accreditation Council for Graduate Medical Education (ACGME) 8 9/25/2012 3:35:15PM

GENERAL UROLOGY OTHER (GENERAL UROLOGY) 49905 Omental flap, intra-abdominal (List separately in addition to code for primary procedure) 50386 Removal (via snare/capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation 51020 Cystotomy or cystostomy; with fulguration and/or insertion of radioactive material 51030 Cystotomy or cystostomy; with cryosurgical destruction of intravesical lesion 51040 Cystostomy, cystotomy with drainage 51045 Cystotomy, with insertion of ureteral catheter or stent (separate procedure) 51050 Cystolithotomy, cystotomy with removal of calculus, without vesical neck resection 51060 Transvesical ureterolithotomy 51065 Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus 51080 Drainage of perivesical or prevesical space abscess 51100 Aspiration of bladder; by needle 51101 Aspiration of bladder; by trocar or intracatheter 51102 Aspiration of bladder; with insertion of suprapubic catheter 51500 Excision of urachal cyst or sinus, with or without umbilical hernia repair 51520 Cystotomy; for simple excision of vesical neck (separate procedure) 51525 Cystotomy; for excision of bladder diverticulum, single or multiple (separate procedure) 51530 Cystotomy; for excision of bladder tumor 51535 GU Cystotomy for excision, incision, or repair of ureterocele 51705 Change of cystostomy tube; simple 51710 Change of cystostomy tube; complicated 51860 Cystorrhaphy, suture of bladder wound, injury or rupture; simple 51865 Cystorrhaphy, suture of bladder wound, injury or rupture; complicated 51880 Closure of cystostomy (separate procedure) 53020 Meatotomy, cutting of meatus (separate procedure); except infant 53040 Drainage of deep periurethral abscess 53060 Drainage of Skene's gland abscess or cyst 53080 Drainage of perineal urinary extravasation; uncomplicated (separate procedure) 53085 Drainage of perineal urinary extravasation; complicated 53200 Biopsy of urethra 53220 Excision or fulguration of carcinoma of urethra 53250 Excision of bulbourethral gland (Cowper's gland) 53260 Excision or fulguration; urethral polyp(s), distal urethra 53265 Excision or fulguration; urethral caruncle 53270 Excision or fulguration; Skene's glands 53275 Excision or fulguration; urethral prolapse 53600 Dilation of urethral stricture by passage of sound or urethral dilator, male; initial 53601 Dilation of urethral stricture by passage of sound or urethral dilator, male; subsequent 53605 Dilation of urethral stricture or vesical neck by passage of sound or urethral dilator, male, general or conduction (spinal) anesthesia 53620 Dilation of urethral stricture by passage of filiform and follower, male; initial 53621 Dilation of urethral stricture by passage of filiform and follower, male; subsequent 53660 Dilation of female urethra including suppository and/or instillation; initial 53661 Dilation of female urethra including suppository and/or instillation; subsequent 53665 Dilation of female urethra, general or conduction (spinal) anesthesia 2012 Accreditation Council for Graduate Medical Education (ACGME) 9 9/25/2012 3:35:17PM

GENERAL UROLOGY OTHER (GENERAL UROLOGY) 53899 Unlisted procedure, urinary system 54015 Incision and drainage of penis, deep 54050 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; chemical 54055 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; electrodesiccation 54056 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; cryosurgery 54057 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; laser surgery 54060 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), simple; surgical excision 54065 Destruction of lesion(s), penis (eg, condyloma, papilloma, molluscum contagiosum, herpetic vesicle), extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) 54150 Circumcision, using clamp or other device with regional dorsal penile or ring block 54160 Circumcision, surgical excision other than clamp, device, or dorsal slit; neonate (28 days of age or less) 54161 Circumcision, surgical excision other than clamp, device, or dorsal slit; older than 28 days of age 54162 Lysis or excision of penile post-circumcision adhesions 54163 Repair incomplete circumcision 54164 Frenulotomy of penis 55600 Vesiculotomy; 55605 Vesiculotomy; complicated 55650 Vesiculectomy, any approach 55680 Excision of Mullerian duct cyst 55870 Electroejaculation 55920 Placement of needles or catheters into pelvic organs and/or genitalia (except prostate) for subsequent interstitial radioelement application 58740 Lysis of adhesions (salpingolysis, ovariolysis) 69990 Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) SCROTAL/INGUINAL SURGERY 54500 GU/SC Biopsy of testis, needle (separate procedure) 54505 GU/SC Biopsy of testis, incisional (separate procedure) 54512 GU/SC Excision of extraparenchymal lesion of testis 54520 GU/SC Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach 54522 GU/SC Orchiectomy, partial 54530 GU/SC Orchiectomy, radical, for tumor; inguinal approach 54535 GU/SC Orchiectomy, radical, for tumor; with abdominal exploration 54550 GU/SC Exploration for undescended testis (inguinal or scrotal area) 54560 GU/SC Exploration for undescended testis with abdominal exploration 2012 Accreditation Council for Graduate Medical Education (ACGME) 10 9/25/2012 3:35:17PM

GENERAL UROLOGY SCROTAL/INGUINAL SURGERY 54600 GU/SC Reduction of torsion of testis, surgical, with or without fixation of contralateral testis 54620 GU/SC Fixation of contralateral testis (separate procedure) 54640 GU/SC Orchiopexy, inguinal approach, with or without hernia repair 54650 GU/SC Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) 54660 GU/SC Insertion of testicular prosthesis (separate procedure) 54670 Suture or repair of testicular injury 54680 GU/SC Transplantation of testis(es) to thigh (because of scrotal destruction) 54690 GU/SC Laparoscopy, surgical; orchiectomy 54692 GU/SC Laparoscopy, surgical; orchiopexy for intra-abdominal testis 54699 GU/SC Unlisted laparoscopy procedure, testis 54700 GU/SC Incision and drainage of epididymis, testis and/or scrotal space (eg, abscess or hematoma) 54800 GU/SC Biopsy of epididymis, needle 54830 GU/SC Excision of local lesion of epididymis 54840 GU/SC Excision of spermatocele, with or without epididymectomy 54860 GU/SC Epididymectomy; unilateral 54861 GU/SC Epididymectomy; bilateral 54865 GU/SC Exploration of epididymis, with or without biopsy 54900 GU/SC Epididymovasostomy, anastomosis of epididymis to vas deferens; unilateral 54901 GU/SC Epididymovasostomy, anastomosis of epididymis to vas deferens; bilateral 55000 GU/SC Puncture aspiration of hydrocele, tunica vaginalis, with or without injection of medication 55040 GU/SC Excision of hydrocele; unilateral 55041 GU/SC Excision of hydrocele; bilateral 55060 GU/SC Repair of tunica vaginalis hydrocele (Bottle type) 55100 GU/SC Drainage of scrotal wall abscess 55110 GU/SC Scrotal exploration 55120 GU/SC Removal of foreign body in scrotum 55150 GU/SC Resection of scrotum 55175 GU/SC Scrotoplasty; simple 55180 GU/SC Scrotoplasty; complicated 55200 GU/SC Vasotomy, cannulization with or without incision of vas, unilateral or bilateral (separate procedure) 55250 GU/SC Vasectomy, unilateral or bilateral (separate procedure), including postoperative semen examination(s) 55300 GU/SC Vasotomy for vasograms, seminal vesiculograms, or epididymograms, unilateral or bilateral 55400 GU/SC Vasovasostomy, vasovasorrhaphy 55450 GU/SC Ligation (percutaneous) of vas deferens, unilateral or bilateral (separate procedure) 55500 GU/SC Excision of hydrocele of spermatic cord, unilateral (separate procedure) 55520 GU/SC Excision of lesion of spermatic cord (separate procedure) 55530 GU/SC Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) 55535 GU/SC Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach 55540 GU/SC Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair 55550 GU/SC Laparoscopy, surgical, with ligation of spermatic veins for varicocele 55559 GU/SC Unlisted laparoscopy procedure, spermatic cord 2012 Accreditation Council for Graduate Medical Education (ACGME) 11 9/25/2012 3:35:17PM

GENERAL UROLOGY TRANSURETHRAL 52224 GU/TUR Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy 52234 GU/TUR Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) 52235 GU/TUR Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) 52240 GU/TUR Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) 52402 GU/TUR Cystourethroscopy with transurethral resection or incision of ejaculatory ducts 52450 GU/TUR Transurethral incision of prostate 52500 GU/TUR Transurethral resection of bladder neck (separate procedure) 52601 GU/TUR Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52630 GU/TUR Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52640 GU/TUR Transurethral resection; of postoperative bladder neck contracture 52647 GU/TUR Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included if performed) 52648 GU/TUR Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed) 52649 GU/TUR Laser enucleation of the prostate with morcellation, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed) 53850 GU/TUR Transurethral destruction of prostate tissue; by microwave thermotherapy 53852 GU/TUR Transurethral destruction of prostate tissue; by radiofrequency thermotherapy TRUS/PROSTATE BIOPSY 55700 GU/TURP Biopsy, prostate; needle or punch, single or multiple, any approach 55705 GU/TURP Biopsy, prostate; incisional, any approach 55706 GU/TURP Biopsies, prostate, needle, transperineal, stereotactic template guided saturation sampling, including imaging guidance 55720 GU/TURP Prostatotomy, external drainage of prostatic abscess, any approach; simple 55725 GU/TURP Prostatotomy, external drainage of prostatic abscess, any approach; complicated ULTRASOUND (GENERAL UROLOGY) 76872 Ultrasound, transrectal; 2012 Accreditation Council for Graduate Medical Education (ACGME) 12 9/25/2012 3:35:18PM

GENERAL UROLOGY ULTRASOUND (GENERAL UROLOGY) 76873 Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) 76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation 76998 Ultrasonic guidance, intraoperative 77776 Interstitial radiation source application; simple 77777 Interstitial radiation source application; intermediate 77778 Interstitial radiation source application; complex URODYNAMICS (GENERAL UROLOGY) 50396 GU/UD Manometric studies through nephrostomy or pyelostomy tube, or indwelling ureteral catheter 51720 Bladder instillation of anticarcinogenic agent (including retention time) 51725 Simple cystometrogram (CMG) (eg, spinal manometer) 51726 GU/UD Complex cystometrogram (ie, calibrated electronic equipment); 51736 Simple uroflowmetry (UFR) (eg, stop-watch flow rate, mechanical uroflowmeter) 51741 Complex uroflowmetry (eg, calibrated electronic equipment) 51772 GU/UD Urethral pressure profile studies (UPP) (urethral closure pressure profile), any technique 51784 GU/UD Electromyography studies (EMG) of anal or urethral sphincter, other than needle, any technique 51785 GU/UD Needle electromyography studies (EMG) of anal or urethral sphincter, any technique 51792 Stimulus evoked response (eg, measurement of bulbocavernosus reflex latency time) 51795 GU/UD Voiding pressure studies (VP); bladder voiding pressure, any technique 51797 GU/UD Voiding pressure studies, intra-abdominal (ie, rectal, gastric, intraperitoneal) (List separately in addition to code for primary procedure) 51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging NON-TRUS BIOPSY ULTRASOUND PROCEDURES PELVIC (ULTRASOUND) 51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging 76856 Ultrasound, pelvic (nonobstetric), real time with image documentation; complete 76857 Ultrasound, pelvic (nonobstetric), real time with image documentation; limited or follow-up (eg, for follicles) PENILE (ULTRASOUND) 93980 Duplex scan of arterial inflow and venous outflow of penile vessels; complete study 2012 Accreditation Council for Graduate Medical Education (ACGME) 13 9/25/2012 3:35:18PM

NON-TRUS BIOPSY ULTRASOUND PROCEDURES PENILE (ULTRASOUND) 93981 Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study PROSTATE (ULTRASOUND) 55873 Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) 76872 Ultrasound, transrectal; 76873 Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) 76942 Ultrasonic guidance for needle placement (eg, biopsy, aspiration, injection, localization device), imaging supervision and interpretation RENAL (ULTRASOUND) 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76775 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited 76776 Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation 76940 Ultrasound guidance for, and monitoring of, parenchymal tissue ablation 76998 Ultrasonic guidance, intraoperative SCROTAL (ULTRASOUND) 76870 Ultrasound, scrotum and contents ONCOLOGY OTHER (ONCOLOGY) 38571 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy 38572 Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple 38770 Pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) PELVIC - BLADDER 51550 PEL/P-BL Cystectomy, partial; simple 51555 PEL/P-BL Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) 2012 Accreditation Council for Graduate Medical Education (ACGME) 14 9/25/2012 3:35:20PM

ONCOLOGY PELVIC - BLADDER 51565 PEL/P-BL Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) 51570 PEL/P-BL Cystectomy, complete; (separate procedure) 51575 PEL/P-BL Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51580 PEL/P-BL Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; 51585 PEL/P-BL Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51590 PEL/P-BL Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; 51595 PEL/P-BL Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51596 PEL/P-BL Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder 51597 PEL/P-BL Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof 51999 PEL/P-BL Unlisted laparoscopy procedure, bladder 58240 PEL/P-BL Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof PELVIC - OTHER 38562 PEL Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic 38760 PEL Inguinofemoral lymphadenectomy, superficial, including Cloquets node (separate procedure) 38765 PEL Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) 49250 Umbilectomy, omphalectomy, excision of umbilicus (separate procedure) PELVIC - PROSTATE 55801 PEL/P-PR Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) 55810 PEL/P-PR Prostatectomy, perineal radical; 55812 PEL/P-PR Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) 55815 PEL/P-PR Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 55821 PEL/P-PR Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages 55831 PEL/P-PR Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal 2012 Accreditation Council for Graduate Medical Education (ACGME) 15 9/25/2012 3:35:20PM

ONCOLOGY PELVIC - PROSTATE 55840 PEL/P-PR Prostatectomy, retropubic radical, with or without nerve sparing; 55842 PEL/P-PR Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) 55845 PEL/P-PR Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 55860 Exposure of prostate, any approach, for insertion of radioactive substance; 55862 Exposure of prostate, any approach, for insertion of radioactive substance; with lymph node biopsy(s) (limited pelvic lymphadenectomy) 55865 Exposure of prostate, any approach, for insertion of radioactive substance; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 55866 PEL/P-PR Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed 55873 Cryosurgical ablation of the prostate (includes ultrasonic guidance and monitoring) RETROPERITONEAL - ADRENAL 60540 RET Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); 60545 RET Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor 60650 RET Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal RETROPERITONEAL - KIDNEY 50010 Renal exploration, not necessitating other specific procedures 50020 Drainage of perirenal or renal abscess; open 50021 Drainage of perirenal or renal abscess; percutaneous 50040 Nephrostomy, nephrotomy with drainage 50045 Nephrotomy, with exploration 50100 Transection or repositioning of aberrant renal vessels (separate procedure) 50120 Pyelotomy; with exploration 50125 Pyelotomy; with drainage, pyelostomy 50200 Renal biopsy; percutaneous, by trocar or needle 50205 Renal biopsy; by surgical exposure of kidney 50220 RET/KID Nephrectomy, including partial ureterectomy, any open approach including rib resection; 50225 RET/KID Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney 50230 RET/KID Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy 50234 RET/KID Nephrectomy with total ureterectomy and bladder cuff; through same incision 50236 RET/KID Nephrectomy with total ureterectomy and bladder cuff; through separate incision 50240 RET/KID Nephrectomy, partial 2012 Accreditation Council for Graduate Medical Education (ACGME) 16 9/25/2012 3:35:22PM

ONCOLOGY RETROPERITONEAL - KIDNEY 50250 RET/KID Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed 50280 RET/KID Excision or unroofing of cyst(s) of kidney 50290 RET/KID Excision of perinephric cyst 50300 RET/KID Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral 50320 RET/KID Donor nephrectomy (including cold preservation); open, from living donor 50323 Backbench standard preparation of cadaver donor renal allograft prior to transplantation, including dissection and removal of perinephric fat, diaphragmatic and retroperitoneal attachments, excision of adrenal gland, and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary 50325 Backbench standard preparation of living donor renal allograft (open or laparoscopic) prior to transplantation, including dissection and removal of perinephric fat and preparation of ureter(s), renal vein(s), and renal artery(s), ligating branches, as necessary 50327 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; venous anastomosis, each 50328 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each 50329 Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; ureteral anastomosis, each 50340 RET/KID Recipient nephrectomy (separate procedure) 50360 RET/KID Renal allotransplantation, implantation of graft; without recipient nephrectomy 50365 RET/KID Renal allotransplantation, implantation of graft; with recipient nephrectomy 50370 RET/KID Removal of transplanted renal allograft 50380 RET/KID Renal autotransplantation, reimplantation of kidney 50540 Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation) 50541 RET/KID Laparoscopy, surgical; ablation of renal cysts 50542 RET/KID Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed 50543 RET/KID Laparoscopy, surgical; partial nephrectomy 50545 RET/KID Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) 50546 RET/KID Laparoscopy, surgical; nephrectomy, including partial ureterectomy 50547 RET/KID Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor 50548 RET/KID Laparoscopy, surgical; nephrectomy with total ureterectomy 50549 RET/KID Unlisted laparoscopy procedure, renal RETROPERITONEAL - OTHER 49180 Biopsy, abdominal or retroperitoneal mass, percutaneous needle 49321 Laparoscopy, surgical; with biopsy (single or multiple) RETROPERITONEAL - RPLND 2012 Accreditation Council for Graduate Medical Education (ACGME) 17 9/25/2012 3:35:22PM

ONCOLOGY RETROPERITONEAL - RPLND 38564 RET Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) 38570 RET/LAP Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple 38780 RET Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) 49203 RET Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less 49204 RET Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter 49205 RET Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter PEDIATRICS MAJOR - HYPOSPADIAS 53235 MAJ/HYP Excision of urethral diverticulum (separate procedure); male 53240 MAJ/HYP Marsupialization of urethral diverticulum, male or female 53400 MAJ/HYP Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) 53405 MAJ/HYP Urethroplasty; second stage (formation of urethra), including urinary diversion 53410 MAJ/HYP Urethroplasty, 1-stage reconstruction of male anterior urethra 53415 MAJ/HYP Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra 53420 MAJ/HYP Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage 53425 MAJ/HYP Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage 53430 MAJ/HYP Urethroplasty, reconstruction of female urethra 53431 MAJ/HYP Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) 53450 MAJ/HYP Urethromeatoplasty, with mucosal advancement 53460 MAJ/HYP Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) 54300 MAJ/HYP Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra 54304 MAJ/HYP Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps 54308 MAJ/HYP Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm 54312 MAJ/HYP Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm 54316 MAJ/HYP Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia 2012 Accreditation Council for Graduate Medical Education (ACGME) 18 9/25/2012 3:35:23PM

PEDIATRICS MAJOR - HYPOSPADIAS 54318 MAJ/HYP Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) 54322 MAJ/HYP 1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) 54324 MAJ/HYP 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) 54326 MAJ/HYP 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra 54328 MAJ/HYP 1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap 54332 MAJ/HYP 1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap 54336 MAJ/HYP 1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap 54340 MAJ/HYP Repair of hypospadias complications (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple 54344 MAJ/HYP Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft 54348 MAJ/HYP Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring extensive dissection and urethroplasty with flap, patch or tubed graft (includes urinary diversion) 54352 MAJ/HYP Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts 54360 MAJ/HYP Plastic operation on penis to correct angulation 54380 MAJ/HYP Plastic operation on penis for epispadias distal to external sphincter; 54385 MAJ/HYP Plastic operation on penis for epispadias distal to external sphincter; with incontinence 54390 MAJ/HYP Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder 55970 MAJ/HYP Intersex surgery; male to female 55980 MAJ/HYP Intersex surgery; female to male 57220 MAJ/HYP Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) 57335 MAJ/HYP Vaginoplasty for intersex state MAJOR - KIDNEY 50060 MAJ Nephrolithotomy; removal of calculus 50065 MAJ Nephrolithotomy; secondary surgical operation for calculus 50070 MAJ Nephrolithotomy; complicated by congenital kidney abnormality 50075 MAJ Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) 50080 MAJ Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; up to 2 cm 50081 MAJ Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting, or basket extraction; over 2 cm 2012 Accreditation Council for Graduate Medical Education (ACGME) 19 9/25/2012 3:35:23PM

PEDIATRICS MAJOR - KIDNEY 50130 MAJ Pyelotomy; with removal of calculus (pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy) 50135 MAJ Pyelotomy; complicated (eg, secondary operation, congenital kidney abnormality) 50220 MAJ Nephrectomy, including partial ureterectomy, any open approach including rib resection; 50225 MAJ Nephrectomy, including partial ureterectomy, any open approach including rib resection; complicated because of previous surgery on same kidney 50230 MAJ Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy 50234 MAJ Nephrectomy with total ureterectomy and bladder cuff; through same incision 50236 MAJ Nephrectomy with total ureterectomy and bladder cuff; through separate incision 50240 MAJ Nephrectomy, partial 50250 MAJ Ablation, open, 1 or more renal mass lesion(s), cryosurgical, including intraoperative ultrasound guidance and monitoring, if performed 50280 MAJ Excision or unroofing of cyst(s) of kidney 50290 MAJ Excision of perinephric cyst 50300 MAJ Donor nephrectomy (including cold preservation); from cadaver donor, unilateral or bilateral 50320 MAJ Donor nephrectomy (including cold preservation); open, from living donor 50340 MAJ Recipient nephrectomy (separate procedure) 50360 MAJ Renal allotransplantation, implantation of graft; without recipient nephrectomy 50365 MAJ Renal allotransplantation, implantation of graft; with recipient nephrectomy 50370 MAJ Removal of transplanted renal allograft 50380 MAJ Renal autotransplantation, reimplantation of kidney 50500 MAJ Nephrorrhaphy, suture of kidney wound or injury 50520 MAJ Closure of nephrocutaneous or pyelocutaneous fistula 50525 MAJ Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach 50526 MAJ Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach 50541 MAJ/LAP Laparoscopy, surgical; ablation of renal cysts 50542 MAJ/LAP Laparoscopy, surgical; ablation of renal mass lesion(s), including intraoperative ultrasound guidance and monitoring, when performed 50543 MAJ/LAP Laparoscopy, surgical; partial nephrectomy 50545 MAJ/LAP Laparoscopy, surgical; radical nephrectomy (includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy) 50546 MAJ/LAP Laparoscopy, surgical; nephrectomy, including partial ureterectomy 50547 MAJ/LAP Laparoscopy, surgical; donor nephrectomy (including cold preservation), from living donor 50548 MAJ/LAP Laparoscopy, surgical; nephrectomy with total ureterectomy 50549 MAJ/LAP Unlisted laparoscopy procedure, renal MAJOR - OTHER 38562 MAJ Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic 38564 MAJ Limited lymphadenectomy for staging (separate procedure); retroperitoneal (aortic and/or splenic) 38570 MAJ/LAP Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple 38760 MAJ Inguinofemoral lymphadenectomy, superficial, including Cloquets node (separate procedure) 2012 Accreditation Council for Graduate Medical Education (ACGME) 20 9/25/2012 3:35:25PM

PEDIATRICS MAJOR - OTHER 38765 MAJ Inguinofemoral lymphadenectomy, superficial, in continuity with pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes (separate procedure) 38780 MAJ Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes (separate procedure) 49203 MAJ Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5 cm diameter or less 49204 MAJ Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor 5.1-10.0 cm diameter 49205 MAJ Excision or destruction, open, intra-abdominal tumors, cysts or endometriomas, 1 or more peritoneal, mesenteric, or retroperitoneal primary or secondary tumors; largest tumor greater than 10.0 cm diameter 50810 MAJ Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis 50815 MAJ Ureterocolon conduit, including intestine anastomosis 50820 MAJ Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) 50830 MAJ Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) 50840 MAJ Replacement of all or part of ureter by intestine segment, including intestine anastomosis 50845 MAJ Cutaneous appendico-vesicostomy 51550 MAJ Cystectomy, partial; simple 51555 MAJ Cystectomy, partial; complicated (eg, postradiation, previous surgery, difficult location) 51565 MAJ Cystectomy, partial, with reimplantation of ureter(s) into bladder (ureteroneocystostomy) 51570 MAJ Cystectomy, complete; (separate procedure) 51575 MAJ Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51580 MAJ Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; 51585 MAJ Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51590 MAJ Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; 51595 MAJ Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 51596 MAJ Cystectomy, complete, with continent diversion, any open technique, using any segment of small and/or large intestine to construct neobladder 51597 MAJ Pelvic exenteration, complete, for vesical, prostatic or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof 51900 MAJ Closure of vesicovaginal fistula, abdominal approach 51920 MAJ Closure of vesicouterine fistula; 51925 MAJ Closure of vesicouterine fistula; with hysterectomy 51940 MAJ Closure, exstrophy of bladder 51960 MAJ Enterocystoplasty, including intestinal anastomosis 51980 MAJ Cutaneous vesicostomy 2012 Accreditation Council for Graduate Medical Education (ACGME) 21 9/25/2012 3:35:25PM

PEDIATRICS MAJOR - OTHER 53230 MAJ Excision of urethral diverticulum (separate procedure); female 55801 MAJ Prostatectomy, perineal, subtotal (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy) 55810 MAJ Prostatectomy, perineal radical; 55812 MAJ Prostatectomy, perineal radical; with lymph node biopsy(s) (limited pelvic lymphadenectomy) 55815 MAJ Prostatectomy, perineal radical; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 55821 MAJ Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); suprapubic, subtotal, 1 or 2 stages 55831 MAJ Prostatectomy (including control of postoperative bleeding, vasectomy, meatotomy, urethral calibration and/or dilation, and internal urethrotomy); retropubic, subtotal 55840 MAJ Prostatectomy, retropubic radical, with or without nerve sparing; 55842 MAJ Prostatectomy, retropubic radical, with or without nerve sparing; with lymph node biopsy(s) (limited pelvic lymphadenectomy) 55845 MAJ Prostatectomy, retropubic radical, with or without nerve sparing; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes 55866 MAJ/LAP Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed 57291 MAJ Construction of artificial vagina; without graft 57292 MAJ Construction of artificial vagina; with graft 57300 MAJ Closure of rectovaginal fistula; vaginal or transanal approach 57305 MAJ Closure of rectovaginal fistula; abdominal approach 57307 MAJ Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy 57308 MAJ Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication 57310 MAJ Closure of urethrovaginal fistula; 57311 MAJ Closure of urethrovaginal fistula; with bulbocavernosus transplant 57320 MAJ Closure of vesicovaginal fistula; vaginal approach 57330 MAJ Closure of vesicovaginal fistula; transvesical and vaginal approach 58240 MAJ Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with removal of bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof 60540 MAJ Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); 60545 MAJ Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (separate procedure); with excision of adjacent retroperitoneal tumor 60650 MAJ/LAP Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal MAJOR - URETER 50400 MAJ/UR Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple 2012 Accreditation Council for Graduate Medical Education (ACGME) 22 9/25/2012 3:35:26PM

PEDIATRICS MAJOR - URETER 50405 MAJ/UR Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty) 50544 MAJ/UR Laparoscopy, surgical; pyeloplasty 50600 MAJ/UR Ureterotomy with exploration or drainage (separate procedure) 50605 MAJ/UR Ureterotomy for insertion of indwelling stent, all types 50610 MAJ/UR Ureterolithotomy; upper one-third of ureter 50620 MAJ/UR Ureterolithotomy; middle one-third of ureter 50630 MAJ/UR Ureterolithotomy; lower one-third of ureter 50650 MAJ/UR Ureterectomy, with bladder cuff (separate procedure) 50660 MAJ/UR Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach 50700 MAJ/UR Ureteroplasty, plastic operation on ureter (eg, stricture) 50715 MAJ/UR Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis 50722 MAJ/UR Ureterolysis for ovarian vein syndrome 50725 MAJ/UR Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava 50727 MAJ/UR Revision of urinary-cutaneous anastomosis (any type urostomy); 50728 MAJ/UR Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia 50740 MAJ/UR Ureteropyelostomy, anastomosis of ureter and renal pelvis 50750 MAJ/UR Ureterocalycostomy, anastomosis of ureter to renal calyx 50760 MAJ/UR Ureteroureterostomy 50770 MAJ/UR Transureteroureterostomy, anastomosis of ureter to contralateral ureter 50780 MAJ/UR Ureteroneocystostomy; anastomosis of single ureter to bladder 50782 MAJ/UR Ureteroneocystostomy; anastomosis of duplicated ureter to bladder 50783 MAJ/UR Ureteroneocystostomy; with extensive ureteral tailoring 50785 MAJ/UR Ureteroneocystostomy; with vesico-psoas hitch or bladder flap 50800 MAJ/UR Ureteroenterostomy, direct anastomosis of ureter to intestine 50860 MAJ/UR Ureterostomy, transplantation of ureter to skin 50900 MAJ/UR Ureterorrhaphy, suture of ureter (separate procedure) 50920 MAJ/UR Closure of ureterocutaneous fistula 50930 MAJ/UR Closure of ureterovisceral fistula (including visceral repair) 50940 MAJ/UR Deligation of ureter 50945 MAJ/UR Laparoscopy, surgical; ureterolithotomy 50947 MAJ/UR Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement 50948 MAJ/UR Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement 50949 MAJ/UR Unlisted laparoscopy procedure, ureter 51535 MAJ/UR Cystotomy for excision, incision, or repair of ureterocele MINOR - ENDOSCOPIC 0084T MIN/END Insertion of a temporary prostatic urethral stent 2012 Accreditation Council for Graduate Medical Education (ACGME) 23 9/25/2012 3:35:26PM

PEDIATRICS MINOR - ENDOSCOPIC 50385 MIN/END Removal (via snare/capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation 51715 MIN/END Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck 52000 MIN/END Cystourethroscopy (separate procedure) 52001 MIN/END Cystourethroscopy with irrigation and evacuation of multiple obstructing clots 52005 MIN/END Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; 52007 MIN/END Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with brush biopsy of ureter and/or renal pelvis 52010 MIN/END Cystourethroscopy, with ejaculatory duct catheterization, with or without irrigation, instillation, or duct radiography, exclusive of radiologic service 52204 MIN/END Cystourethroscopy, with biopsy(s) 52214 MIN/END Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) of trigone, bladder neck, prostatic fossa, urethra, or periurethral glands 52224 MIN/END Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) or treatment of MINOR (less than 0.5 cm) lesion(s) with or without biopsy 52234 MIN/END Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; SMALL bladder tumor(s) (0.5 up to 2.0 cm) 52235 MIN/END Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; MEDIUM bladder tumor(s) (2.0 to 5.0 cm) 52240 MIN/END Cystourethroscopy, with fulguration (including cryosurgery or laser surgery) and/or resection of; LARGE bladder tumor(s) 52250 MIN/END Cystourethroscopy with insertion of radioactive substance, with or without biopsy or fulguration 52260 MIN/END Cystourethroscopy, with dilation of bladder for interstitial cystitis; general or conduction (spinal) anesthesia 52265 MIN/END Cystourethroscopy, with dilation of bladder for interstitial cystitis; local anesthesia 52270 MIN/END Cystourethroscopy, with internal urethrotomy; female 52275 MIN/END Cystourethroscopy, with internal urethrotomy; male 52276 MIN/END Cystourethroscopy with direct vision internal urethrotomy 52277 MIN/END Cystourethroscopy, with resection of external sphincter (sphincterotomy) 52281 MIN/END Cystourethroscopy, with calibration and/or dilation of urethral stricture or stenosis, with or without meatotomy, with or without injection procedure for cystography, male or female 52282 MIN/END Cystourethroscopy, with insertion of permanent urethral stent 52283 MIN/END Cystourethroscopy, with steroid injection into stricture 52285 MIN/END Cystourethroscopy for treatment of the female urethral syndrome with any or all of the following: urethral meatotomy, urethral dilation, internal urethrotomy, lysis of urethrovaginal septal fibrosis, lateral incisions of the bladder neck, and fulguration of polyp(s) of urethra, bladder neck, and/or trigone 52290 MIN/END Cystourethroscopy; with ureteral meatotomy, unilateral or bilateral 52300 MIN/END Cystourethroscopy; with resection or fulguration of orthotopic ureterocele(s), unilateral or bilateral 52301 MIN/END Cystourethroscopy; with resection or fulguration of ectopic ureterocele(s), unilateral or bilateral 2012 Accreditation Council for Graduate Medical Education (ACGME) 24 9/25/2012 3:35:28PM

PEDIATRICS MINOR - ENDOSCOPIC 52305 MIN/END Cystourethroscopy; with incision or resection of orifice of bladder diverticulum, single or multiple 52310 MIN/END Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); simple 52315 MIN/END Cystourethroscopy, with removal of foreign body, calculus, or ureteral stent from urethra or bladder (separate procedure); complicated 52317 MIN/END Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm) 52318 MIN/END Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; complicated or large (over 2.5 cm) 52320 MIN/END Cystourethroscopy (including ureteral catheterization); with removal of ureteral calculus 52325 MIN/END Cystourethroscopy (including ureteral catheterization); with fragmentation of ureteral calculus (eg, ultrasonic or electro-hydraulic technique) 52327 MIN/END Cystourethroscopy (including ureteral catheterization); with subureteric injection of implant material 52330 MIN/END Cystourethroscopy (including ureteral catheterization); with manipulation, without removal of ureteral calculus 52332 MIN/END Cystourethroscopy, with insertion of indwelling ureteral stent (eg, Gibbons or double-j type) 52334 MIN/END Cystourethroscopy with insertion of ureteral guide wire through kidney to establish a percutaneous nephrostomy, retrograde 52341 MIN/END Cystourethroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) 52342 MIN/END Cystourethroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) 52343 MIN/END Cystourethroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) 52344 MIN/END Cystourethroscopy with ureteroscopy; with treatment of ureteral stricture (eg, balloon dilation, laser, electrocautery, and incision) 52345 MIN/END Cystourethroscopy with ureteroscopy; with treatment of ureteropelvic junction stricture (eg, balloon dilation, laser, electrocautery, and incision) 52346 MIN/END Cystourethroscopy with ureteroscopy; with treatment of intra-renal stricture (eg, balloon dilation, laser, electrocautery, and incision) 52351 MIN/END Cystourethroscopy, with ureteroscopy and/or pyeloscopy; diagnostic 52352 MIN/END Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (ureteral catheterization is included) 52353 MIN/END Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy (ureteral catheterization is included) 52354 MIN/END Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion 52355 MIN/END Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor 52400 MIN/END Cystourethroscopy with incision, fulguration, or resection of congenital posterior urethral valves, or congenital obstructive hypertrophic mucosal folds 52402 MIN/END Cystourethroscopy with transurethral resection or incision of ejaculatory ducts 52450 MIN/END Transurethral incision of prostate 52500 MIN/END Transurethral resection of bladder neck (separate procedure) 2012 Accreditation Council for Graduate Medical Education (ACGME) 25 9/25/2012 3:35:30PM

PEDIATRICS MINOR - ENDOSCOPIC 52601 MIN/END Transurethral electrosurgical resection of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52630 MIN/END Transurethral resection; residual or regrowth of obstructive prostate tissue including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included) 52640 MIN/END Transurethral resection; of postoperative bladder neck contracture 52647 MIN/END Laser coagulation of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, and internal urethrotomy are included if performed) 52648 MIN/END Laser vaporization of prostate, including control of postoperative bleeding, complete (vasectomy, meatotomy, cystourethroscopy, urethral calibration and/or dilation, internal urethrotomy and transurethral resection of prostate are included if performed) 52700 MIN/END Transurethral drainage of prostatic abscess MINOR - HYDROCELE/HERNIA 49491 MIN/HYD Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; reducible 49492 MIN/HYD Repair, initial inguinal hernia, preterm infant (younger than 37 weeks gestation at birth), performed from birth up to 50 weeks postconception age, with or without hydrocelectomy; incarcerated or strangulated 49495 MIN/HYD Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; reducible 49496 MIN/HYD Repair, initial inguinal hernia, full term infant younger than age 6 months, or preterm infant older than 50 weeks postconception age and younger than age 6 months at the time of surgery, with or without hydrocelectomy; incarcerated or strangulated 49500 MIN/HYD Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; reducible 49501 MIN/HYD Repair initial inguinal hernia, age 6 months to younger than 5 years, with or without hydrocelectomy; incarcerated or strangulated 49505 MIN/HYD Repair initial inguinal hernia, age 5 years or older; reducible 49507 MIN/HYD Repair initial inguinal hernia, age 5 years or older; incarcerated or strangulated 49520 MIN/HYD Repair recurrent inguinal hernia, any age; reducible 49521 MIN/HYD Repair recurrent inguinal hernia, any age; incarcerated or strangulated 49560 MIN/HYD Repair initial incisional or ventral hernia; reducible 49561 MIN/HYD Repair initial incisional or ventral hernia; incarcerated or strangulated 49565 MIN/HYD Repair recurrent incisional or ventral hernia; reducible 49566 MIN/HYD Repair recurrent incisional or ventral hernia; incarcerated or strangulated 49585 MIN/HYD Repair umbilical hernia, age 5 years or older; reducible 49587 MIN/HYD Repair umbilical hernia, age 5 years or older; incarcerated or strangulated 54520 MIN/HYD Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach 54522 MIN/HYD Orchiectomy, partial 2012 Accreditation Council for Graduate Medical Education (ACGME) 26 9/25/2012 3:35:32PM

PEDIATRICS MINOR - HYDROCELE/HERNIA 54530 MIN/HYD Orchiectomy, radical, for tumor; inguinal approach 54535 MIN/HYD Orchiectomy, radical, for tumor; with abdominal exploration 55040 MIN/HYD Excision of hydrocele; unilateral 55041 MIN/HYD Excision of hydrocele; bilateral 55060 MIN/HYD Repair of tunica vaginalis hydrocele (Bottle type) 55500 MIN/HYD Excision of hydrocele of spermatic cord, unilateral (separate procedure) MINOR - ORCHIOPEXY 54550 MIN/ORC Exploration for undescended testis (inguinal or scrotal area) 54560 MIN/ORC Exploration for undescended testis with abdominal exploration 54600 MIN/ORC Reduction of torsion of testis, surgical, with or without fixation of contralateral testis 54620 MIN/ORC Fixation of contralateral testis (separate procedure) 54640 MIN/ORC Orchiopexy, inguinal approach, with or without hernia repair 54650 MIN/ORC Orchiopexy, abdominal approach, for intra-abdominal testis (eg, Fowler-Stephens) 54690 MIN/ORC Laparoscopy, surgical; orchiectomy 54692 MIN/ORC Laparoscopy, surgical; orchiopexy for intra-abdominal testis MINOR - OTHER 53025 MIN Meatotomy, cutting of meatus (separate procedure); infant 54000 MIN Slitting of prepuce, dorsal or lateral (separate procedure); newborn 54001 MIN Slitting of prepuce, dorsal or lateral (separate procedure); except newborn 54120 MIN Amputation of penis; partial 54125 MIN Amputation of penis; complete 54130 MIN Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy 54135 MIN Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 54450 MIN Foreskin manipulation including lysis of preputial adhesions and stretching 54660 MIN Insertion of testicular prosthesis (separate procedure) 54680 MIN Transplantation of testis(es) to thigh (because of scrotal destruction) 54699 MIN/LAP Unlisted laparoscopy procedure, testis 55520 MIN Excision of lesion of spermatic cord (separate procedure) 55530 MIN Excision of varicocele or ligation of spermatic veins for varicocele; (separate procedure) 55535 MIN Excision of varicocele or ligation of spermatic veins for varicocele; abdominal approach 55540 MIN Excision of varicocele or ligation of spermatic veins for varicocele; with hernia repair 55550 MIN/LAP Laparoscopy, surgical, with ligation of spermatic veins for varicocele 55559 MIN/LAP Unlisted laparoscopy procedure, spermatic cord 56441 MIN Lysis of labial adhesions 56442 MIN Hymenotomy, simple incision 56800 MIN Plastic repair of introitus 56805 MIN Clitoroplasty for intersex state 2012 Accreditation Council for Graduate Medical Education (ACGME) 27 9/25/2012 3:35:32PM

RADIOLOGIC FLUOROSCOPY 50684 Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter 50688 Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit 50690 Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service 51600 Injection procedure for cystography or voiding urethrocystography 51605 Injection procedure and placement of chain for contrast and/or chain urethrocystography 51610 Injection procedure for retrograde urethrocystography 74400 Urography (pyelography), intravenous, with or without KUB, with or without tomography 74410 Urography, infusion, drip technique and/or bolus technique; 74415 Urography, infusion, drip technique and/or bolus technique; with nephrotomography 74420 Urography, retrograde, with or without KUB 74425 Urography, antegrade (pyelostogram, nephrostogram, loopogram), radiological supervision and interpretation 74430 Cystography, minimum of 3 views, radiological supervision and interpretation 74440 Vasography, vesiculography, or epididymography, radiological supervision and interpretation 74445 Corpora cavernosography, radiological supervision and interpretation 74450 Urethrocystography, retrograde, radiological supervision and interpretation 74455 Urethrocystography, voiding, radiological supervision and interpretation 74470 Radiologic examination, renal cyst study, translumbar, contrast visualization, radiological supervision and interpretation 74475 Introduction of intracatheter or catheter into renal pelvis for drainage and/or injection, percutaneous, radiological supervision and interpretation 74480 Introduction of ureteral catheter or stent into ureter through renal pelvis for drainage and/or injection, percutaneous, radiological supervision and interpretation 74485 Dilation of nephrostomy, ureters, or urethra, radiological supervision and interpretation 76000 Fluoroscopy (separate procedure), up to 1 hour physician time, other than 71023 or 71034 (eg, cardiac fluoroscopy) 76001 Fluoroscopy, physician time more than 1 hour, assisting a nonradiologic physician (eg, nephrostolithotomy, ERCP, bronchoscopy, transbronchial biopsy) OTHER - RADIOLOGIC 51700 Bladder irrigation, simple, lavage and/or instillation 51701 Insertion of non-indwelling bladder catheter (eg, straight catheterization for residual urine) 51702 Insertion of temporary indwelling bladder catheter; simple (eg, Foley) 51703 Insertion of temporary indwelling bladder catheter; complicated (eg, altered anatomy, fractured catheter/balloon) ULTRASOUND (RADIOLOGIC) 55875 Transperineal placement of needles or catheters into prostate for interstitial radioelement application, with or without cystoscopy 2012 Accreditation Council for Graduate Medical Education (ACGME) 28 9/25/2012 3:35:33PM

RADIOLOGIC ULTRASOUND (RADIOLOGIC) 55876 Placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), prostate (via needle, any approach), single or multiple 76700 Ultrasound, abdominal, real time with image documentation; complete 76705 Ultrasound, abdominal, real time with image documentation; limited (eg, single organ, quadrant, follow-up) 76770 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete 76775 Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited 76776 Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation 76870 Ultrasound, scrotum and contents URODYNAMICS (RADIOLOGIC) 50686 Manometric studies through ureterostomy or indwelling ureteral catheter RECONSTRUCTIVE SURGERY FEMALE 51715 Endoscopic injection of implant material into the submucosal tissues of the urethra and/or bladder neck 51840 REC/FEM Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); simple 51841 REC/FEM Anterior vesicourethropexy, or urethropexy (eg, Marshall-Marchetti-Krantz, Burch); complicated (eg, secondary repair) 51845 REC/FEM Abdomino-vaginal vesical neck suspension, with or without endoscopic control (eg, Stamey, Raz, modified Pereyra) 51990 REC/FEM Laparoscopy, surgical; urethral suspension for stress incontinence 51992 REC/FEM Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic) 53210 REC/FEM Urethrectomy, total, including cystostomy; female 53230 REC/FEM Excision of urethral diverticulum (separate procedure); female 53240 REC/FEM Marsupialization of urethral diverticulum, male or female 55970 REC/FEM Intersex surgery; male to female 56441 Lysis of labial adhesions 56442 Hymenotomy, simple incision 56800 REC/FEM Plastic repair of introitus 56805 REC/FEM Clitoroplasty for intersex state 56810 Perineoplasty, repair of perineum, nonobstetrical (separate procedure) 57000 Colpotomy; with exploration 57010 Colpotomy; with drainage of pelvic abscess 57020 Colpocentesis (separate procedure) 57022 Incision and drainage of vaginal hematoma; obstetrical/postpartum 57023 Incision and drainage of vaginal hematoma; non-obstetrical (eg, post-trauma, spontaneous bleeding) 2012 Accreditation Council for Graduate Medical Education (ACGME) 29 9/25/2012 3:35:33PM

RECONSTRUCTIVE SURGERY FEMALE 57061 Destruction of vaginal lesion(s); simple (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) 57065 Destruction of vaginal lesion(s); extensive (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery) 57100 Biopsy of vaginal mucosa; simple (separate procedure) 57105 Biopsy of vaginal mucosa; extensive, requiring suture (including cysts) 57106 REC/FEM Vaginectomy, partial removal of vaginal wall; 57107 REC/FEM Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) 57109 REC/FEM Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) 57110 REC/FEM Vaginectomy, complete removal of vaginal wall; 57111 REC/FEM Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) 57112 REC/FEM Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy) 57120 REC/FEM Colpocleisis (Le Fort type) 57130 Excision of vaginal septum 57135 REC/FEM Excision of vaginal cyst or tumor 57150 Irrigation of vagina and/or application of medicament for treatment of bacterial, parasitic, or fungoid disease 57155 Insertion of uterine tandems and/or vaginal ovoids for clinical brachytherapy 57160 Fitting and insertion of pessary or other intravaginal support device 57170 Diaphragm or cervical cap fitting with instructions 57180 Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure) 57200 Colporrhaphy, suture of injury of vagina (nonobstetrical) 57210 Colpoperineorrhaphy, suture of injury of vagina and/or perineum (nonobstetrical) 57220 REC/FEM Plastic operation on urethral sphincter, vaginal approach (eg, Kelly urethral plication) 57230 REC/FEM Plastic repair of urethrocele 57240 REC/FEM Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele 57250 REC/FEM Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy 57260 REC/FEM Combined anteroposterior colporrhaphy; 57265 REC/FEM Combined anteroposterior colporrhaphy; with enterocele repair 57267 REC/FEM Insertion of mesh or other prosthesis for repair of pelvic floor defect, each site (anterior, posterior compartment), vaginal approach (List separately in addition to code for primary procedure) 57268 REC/FEM Repair of enterocele, vaginal approach (separate procedure) 57270 REC/FEM Repair of enterocele, abdominal approach (separate procedure) 57280 REC/FEM Colpopexy, abdominal approach 57282 REC/FEM Colpopexy, vaginal; extra-peritoneal approach (sacrospinous, iliococcygeus) 57283 REC/FEM Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy) 57284 REC/FEM Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach 57285 REC/FEM Paravaginal defect repair (including repair of cystocele, if performed); vaginal approach 2012 Accreditation Council for Graduate Medical Education (ACGME) 30 9/25/2012 3:35:35PM

RECONSTRUCTIVE SURGERY FEMALE 57287 REC/FEM Removal or revision of sling for stress incontinence (eg, fascia or synthetic) 57288 REC/FEM Sling operation for stress incontinence (eg, fascia or synthetic) 57289 REC/FEM Pereyra procedure, including anterior colporrhaphy 57291 REC/FEM Construction of artificial vagina; without graft 57292 REC/FEM Construction of artificial vagina; with graft 57295 REC/FEM Revision (including removal) of prosthetic vaginal graft; vaginal approach 57296 REC/FEM Revision (including removal) of prosthetic vaginal graft; open abdominal approach 57335 REC/FEM Vaginoplasty for intersex state 57400 Dilation of vagina under anesthesia (other than local) 57410 Pelvic examination under anesthesia (other than local) 57415 Removal of impacted vaginal foreign body (separate procedure) under anesthesia (other than local) 57420 Colposcopy of the entire vagina, with cervix if present; 57421 Colposcopy of the entire vagina, with cervix if present; with biopsy(s) of vagina/cervix 57423 REC/FEM Paravaginal defect repair (including repair of cystocele, if performed), laparoscopic approach 57425 REC/FEM Laparoscopy, surgical, colpopexy (suspension of vaginal apex) 58570 REC/FEM Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; 58571 REC/FEM Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) 58956 REC/FEM Bilateral salpingo-oophorectomy with total omentectomy, total abdominal hysterectomy for malignancy 64581 Incision for implantation of neurostimulator electrode array; sacral nerve (transforaminal placement) 64590 Insertion or replacement of peripheral or gastric neurostimulator pulse generator or receiver, direct or inductive coupling INTESTINAL DIVERSION 50810 REC/ID Ureterosigmoidostomy, with creation of sigmoid bladder and establishment of abdominal or perineal colostomy, including intestine anastomosis 50815 REC/ID Ureterocolon conduit, including intestine anastomosis 50820 REC/ID Ureteroileal conduit (ileal bladder), including intestine anastomosis (Bricker operation) 50830 REC/ID Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy) 50840 REC/ID Replacement of all or part of ureter by intestine segment, including intestine anastomosis 50845 REC/ID Cutaneous appendico-vesicostomy 51960 REC/ID Enterocystoplasty, including intestinal anastomosis MALE - PENILE/INCONTINENCE 11004 REC/PEN Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia and perineum 2012 Accreditation Council for Graduate Medical Education (ACGME) 31 9/25/2012 3:35:35PM

RECONSTRUCTIVE SURGERY MALE - PENILE/INCONTINENCE 11005 REC/PEN Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; abdominal wall, with or without fascial closure 11006 REC/PEN Debridement of skin, subcutaneous tissue, muscle and fascia for necrotizing soft tissue infection; external genitalia, perineum and abdominal wall, with or without fascial closure 53440 REC/PEN Sling operation for correction of male urinary incontinence (eg, fascia or synthetic) 53442 REC/PEN Removal or revision of sling for male urinary incontinence (eg, fascia or synthetic) 53444 REC/PEN Insertion of tandem cuff (dual cuff) 53445 REC/PEN Insertion of inflatable urethral/bladder neck sphincter, including placement of pump, reservoir, and cuff 53446 REC/PEN Removal of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff 53447 REC/PEN Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff at the same operative session 53448 REC/PEN Removal and replacement of inflatable urethral/bladder neck sphincter including pump, reservoir, and cuff through an infected field at the same operative session including irrigation and debridement of infected tissue 53449 REC/PEN Repair of inflatable urethral/bladder neck sphincter, including pump, reservoir, and cuff 54100 REC/PEN Biopsy of penis; (separate procedure) 54105 REC/PEN Biopsy of penis; deep structures 54110 REC/PEN Excision of penile plaque (Peyronie disease); 54111 REC/PEN Excision of penile plaque (Peyronie disease); with graft to 5 cm in length 54112 REC/PEN Excision of penile plaque (Peyronie disease); with graft greater than 5 cm in length 54115 REC/PEN Removal foreign body from deep penile tissue (eg, plastic implant) 54120 REC/PEN Amputation of penis; partial 54125 REC/PEN Amputation of penis; complete 54130 REC/PEN Amputation of penis, radical; with bilateral inguinofemoral lymphadenectomy 54135 REC/PEN Amputation of penis, radical; in continuity with bilateral pelvic lymphadenectomy, including external iliac, hypogastric and obturator nodes 54200 Injection procedure for Peyronie disease; 54205 Injection procedure for Peyronie disease; with surgical exposure of plaque 54220 Irrigation of corpora cavernosa for priapism 54230 Injection procedure for corpora cavernosography 54231 Dynamic cavernosometry, including intracavernosal injection of vasoactive drugs (eg, papaverine, phentolamine) 54235 Injection of corpora cavernosa with pharmacologic agent(s) (eg, papaverine, phentolamine) 54240 Penile plethysmography 54250 Nocturnal penile tumescence and/or rigidity test 54300 Plastic operation of penis for straightening of chordee (eg, hypospadias), with or without mobilization of urethra 54304 Plastic operation on penis for correction of chordee or for first stage hypospadias repair with or without transplantation of prepuce and/or skin flaps 54360 REC/PEN Plastic operation on penis to correct angulation 54380 REC/PEN Plastic operation on penis for epispadias distal to external sphincter; 54385 REC/PEN Plastic operation on penis for epispadias distal to external sphincter; with incontinence 54390 REC/PEN Plastic operation on penis for epispadias distal to external sphincter; with exstrophy of bladder 54400 REC/PEN Insertion of penile prosthesis; non-inflatable (semi-rigid) 54401 REC/PEN Insertion of penile prosthesis; inflatable (self-contained) 2012 Accreditation Council for Graduate Medical Education (ACGME) 32 9/25/2012 3:35:37PM

RECONSTRUCTIVE SURGERY MALE - PENILE/INCONTINENCE 54405 REC/PEN Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir 54406 REC/PEN Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis 54408 REC/PEN Repair of component(s) of a multi-component, inflatable penile prosthesis 54410 REC/PEN Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session 54411 REC/PEN Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue 54415 REC/PEN Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis 54416 REC/PEN Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session 54417 REC/PEN Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue 54420 REC/PEN Corpora cavernosa-saphenous vein shunt (priapism operation), unilateral or bilateral 54430 REC/PEN Corpora cavernosa-corpus spongiosum shunt (priapism operation), unilateral or bilateral 54435 REC/PEN Corpora cavernosa-glans penis fistulization (eg, biopsy needle, Winter procedure, rongeur, or punch) for priapism 54440 REC/PEN Plastic operation of penis for injury 55899 Unlisted procedure, male genital system 55980 REC/PEN Intersex surgery; female to male MALE - URETHRA 53000 REC/URTH Urethrotomy or urethrostomy, external (separate procedure); pendulous urethra 53010 REC/URTH Urethrotomy or urethrostomy, external (separate procedure); perineal urethra, external 53215 REC/URTH Urethrectomy, total, including cystostomy; male 53235 REC/URTH Excision of urethral diverticulum (separate procedure); male 53400 REC/URTH Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) 53405 REC/URTH Urethroplasty; second stage (formation of urethra), including urinary diversion 53410 REC/URTH Urethroplasty, 1-stage reconstruction of male anterior urethra 53415 REC/URTH Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra 53420 REC/URTH Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage 53425 REC/URTH Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage 53430 REC/URTH Urethroplasty, reconstruction of female urethra 53431 REC/URTH Urethroplasty with tubularization of posterior urethra and/or lower bladder for incontinence (eg, Tenago, Leadbetter procedure) 53450 REC/URTH Urethromeatoplasty, with mucosal advancement 53460 REC/URTH Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) 2012 Accreditation Council for Graduate Medical Education (ACGME) 33 9/25/2012 3:35:37PM

RECONSTRUCTIVE SURGERY MALE - URETHRA 54308 REC/URTH Urethroplasty for second stage hypospadias repair (including urinary diversion); less than 3 cm 54312 REC/URTH Urethroplasty for second stage hypospadias repair (including urinary diversion); greater than 3 cm 54316 REC/URTH Urethroplasty for second stage hypospadias repair (including urinary diversion) with free skin graft obtained from site other than genitalia 54318 REC/URTH Urethroplasty for third stage hypospadias repair to release penis from scrotum (eg, third stage Cecil repair) 54322 REC/URTH 1-stage distal hypospadias repair (with or without chordee or circumcision); with simple meatal advancement (eg, Magpi, V-flap) 54324 REC/URTH 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps (eg, flip-flap, prepucial flap) 54326 REC/URTH 1-stage distal hypospadias repair (with or without chordee or circumcision); with urethroplasty by local skin flaps and mobilization of urethra 54328 REC/URTH 1-stage distal hypospadias repair (with or without chordee or circumcision); with extensive dissection to correct chordee and urethroplasty with local skin flaps, skin graft patch, and/or island flap 54332 REC/URTH 1-stage proximal penile or penoscrotal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap 54336 REC/URTH 1-stage perineal hypospadias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and/or island flap 54340 REC/URTH Repair of hypospadias complications (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple 54344 REC/URTH Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring mobilization of skin flaps and urethroplasty with flap or patch graft 54348 REC/URTH Repair of hypospadias complications (ie, fistula, stricture, diverticula); requiring extensive dissection and urethroplasty with flap, patch or tubed graft (includes urinary diversion) 54352 REC/URTH Repair of hypospadias cripple requiring extensive dissection and excision of previously constructed structures including re-release of chordee and reconstruction of urethra and penis by use of local skin as grafts and island flaps and skin brought in as flaps or grafts OTHER (RECONSTRUCTIVE SURGERY) 50860 REC Ureterostomy, transplantation of ureter to skin 51800 REC Cystoplasty or cystourethroplasty, plastic operation on bladder and/or vesical neck (anterior Y-plasty, vesical fundus resection), any procedure, with or without wedge resection of posterior vesical neck 51820 REC Cystourethroplasty with unilateral or bilateral ureteroneocystostomy 51940 REC Closure, exstrophy of bladder 51980 REC Cutaneous vesicostomy OTHER RECONSTRUCTIVE SURGERY - FISTULA 50920 REC Closure of ureterocutaneous fistula 50930 REC Closure of ureterovisceral fistula (including visceral repair) 2012 Accreditation Council for Graduate Medical Education (ACGME) 34 9/25/2012 3:35:38PM

RECONSTRUCTIVE SURGERY OTHER RECONSTRUCTIVE SURGERY - FISTULA 51900 REC/FEM Closure of vesicovaginal fistula, abdominal approach 51920 REC/FEM Closure of vesicouterine fistula; 51925 REC/FEM Closure of vesicouterine fistula; with hysterectomy 53500 REC/FEM Urethrolysis, transvaginal, secondary, open, including cystourethroscopy (eg, postsurgical obstruction, scarring) 53520 REC Closure of urethrostomy or urethrocutaneous fistula, male (separate procedure) 57300 REC/FEM Closure of rectovaginal fistula; vaginal or transanal approach 57305 REC/FEM Closure of rectovaginal fistula; abdominal approach 57307 REC/FEM Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy 57308 REC/FEM Closure of rectovaginal fistula; transperineal approach, with perineal body reconstruction, with or without levator plication 57310 REC/FEM Closure of urethrovaginal fistula; 57311 REC/FEM Closure of urethrovaginal fistula; with bulbocavernosus transplant 57320 REC/FEM Closure of vesicovaginal fistula; vaginal approach 57330 REC/FEM Closure of vesicovaginal fistula; transvesical and vaginal approach OTHER RECONSTRUCTIVE SURGERY - KIDNEY 50400 REC Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple 50405 REC Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty) 50500 REC Nephrorrhaphy, suture of kidney wound or injury 50520 REC Closure of nephrocutaneous or pyelocutaneous fistula 50525 REC Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; abdominal approach 50526 REC Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach 50544 REC/LAP Laparoscopy, surgical; pyeloplasty OTHER RECONSTRUCTIVE SURGERY - TRAUMA 13131 REC Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm 13132 REC Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm 53502 REC Urethrorrhaphy, suture of urethral wound or injury, female 53505 REC Urethrorrhaphy, suture of urethral wound or injury; penile 53510 REC Urethrorrhaphy, suture of urethral wound or injury; perineal 53515 REC Urethrorrhaphy, suture of urethral wound or injury; prostatomembranous 2012 Accreditation Council for Graduate Medical Education (ACGME) 35 9/25/2012 3:35:38PM

RECONSTRUCTIVE SURGERY OTHER RECONSTRUCTIVE SURGERY - URETER 50700 REC Ureteroplasty, plastic operation on ureter (eg, stricture) 50715 REC Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis 50722 REC Ureterolysis for ovarian vein syndrome 50725 REC Ureterolysis for retrocaval ureter, with reanastomosis of upper urinary tract or vena cava 50727 REC Revision of urinary-cutaneous anastomosis (any type urostomy); 50728 REC Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia 50740 REC Ureteropyelostomy, anastomosis of ureter and renal pelvis 50750 REC Ureterocalycostomy, anastomosis of ureter to renal calyx 50760 REC Ureteroureterostomy 50770 REC Transureteroureterostomy, anastomosis of ureter to contralateral ureter 50780 REC Ureteroneocystostomy; anastomosis of single ureter to bladder 50782 REC Ureteroneocystostomy; anastomosis of duplicated ureter to bladder 50783 REC Ureteroneocystostomy; with extensive ureteral tailoring 50785 REC Ureteroneocystostomy; with vesico-psoas hitch or bladder flap 50800 REC Ureteroenterostomy, direct anastomosis of ureter to intestine 50900 Ureterorrhaphy, suture of ureter (separate procedure) 50940 Deligation of ureter 50947 REC/LAP Laparoscopy, surgical; ureteroneocystostomy with cystoscopy and ureteral stent placement 50948 REC/LAP Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement 50949 REC/LAP Unlisted laparoscopy procedure, ureter 2012 Accreditation Council for Graduate Medical Education (ACGME) 36 9/25/2012 3:34:48PM