<\/p>\n
<\/p>\n
CPT Code<\/strong><\/th>\n<\/tr>\n| 10021 – Fine needle aspiration; w\/o imaging guid<\/td>\n<\/tr>\n | 10060 – Incision and drainage abscess, simple<\/td>\n<\/tr>\n | 10061 – Incision and drainage abscess, compl\/mult<\/td>\n<\/tr>\n | 10120 – Incision and removal foreign body, subcutaneous tissue, simple<\/td>\n<\/tr>\n | 10121 – Incision and removal foreign body, subcutaneous tissue, complicated<\/td>\n<\/tr>\n | 10140 – Incision drainage of hematoma, seroma<\/td>\n<\/tr>\n | 10160 – Puncture aspiration abscess, hematoma<\/td>\n<\/tr>\n | 10180 – Incision drainage, post operative wound infection<\/td>\n<\/tr>\n | 11010 – Debridement including removal of foreign material at the site of an open fracture and\/or an open dislocation (eg, excisional debridement); skin and subcutaneous tissues<\/td>\n<\/tr>\n | 11011 – Debridement including removal of foreign material at the site of an open fracture and\/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, and muscle<\/td>\n<\/tr>\n | 11012 – Debridement including removal of foreign material at the site of an open fracture and\/or an open dislocation (eg, excisional debridement); skin, subcutaneous tissue, muscle fascia, muscle and bone<\/td>\n<\/tr>\n | 11042 – Debridement, subcutaneous tissue (includes epidermis and dermis, if perfomred); first 20 sq cm or less<\/td>\n<\/tr>\n | 11043 – Debridement, muscle and\/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); first 20 sq cm or less<\/td>\n<\/tr>\n | 11044 – Debridement, bone; first 20 sq cm or less<\/td>\n<\/tr>\n | 11045 – Debridement, subcutaneous tissue (includes epidermis and dermis, if perfomred); each additional 20 sq cm or part thereof(list separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 11046 – Debridement, muscle and\/or fascia (includes epidermis, dermis, and subcutaneous tissue, if performed); each additional 20 sq cm or part thereof (list separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 11047 – Debridement, bone; each additional 20 sq cm, or part thereof<\/td>\n<\/tr>\n | 11305 – Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less<\/td>\n<\/tr>\n | 11306 – Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 11307 – Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 11308 – Shaving of epidermal or dermal lesion, single lesion, scalp, neck, hands, feet, genitalia; lesion diameter over 2.0 cm<\/td>\n<\/tr>\n | 11310 – Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less<\/td>\n<\/tr>\n | 11311 – Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 11312 – Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 11313 – Shaving of epidermal or dermal lesion, single lesion, face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 2.0 cm<\/td>\n<\/tr>\n | 11420 – Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 11426 – Excision, benign lesion including margins, except skin tag (unless listed elsewhere), scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm<\/td>\n<\/tr>\n | 11440 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less<\/td>\n<\/tr>\n | 11441 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 11442 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 11443 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm<\/td>\n<\/tr>\n | 11444 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm<\/td>\n<\/tr>\n | 11446 – Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm<\/td>\n<\/tr>\n | 11620 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less<\/td>\n<\/tr>\n | 11621 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 11622 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 11623 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm<\/td>\n<\/tr>\n | 11624 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm<\/td>\n<\/tr>\n | 11626 – Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm<\/td>\n<\/tr>\n | 11640 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less<\/td>\n<\/tr>\n | 11641 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 11642 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 11643 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm<\/td>\n<\/tr>\n | 11644 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm<\/td>\n<\/tr>\n | 11646 – Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm<\/td>\n<\/tr>\n | 11950 – Subcutaneous injection of filling material (eg, collagen); 1 cc or less<\/td>\n<\/tr>\n | 11951 – Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc<\/td>\n<\/tr>\n | 11952 – Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc<\/td>\n<\/tr>\n | 11954 – Subcutaneous injection of filling material (eg, collagen); over 10.0 cc<\/td>\n<\/tr>\n | 11960 – Insertion of tissue expander(s) for other than breast, including subsequent expansion<\/td>\n<\/tr>\n | 11971 – Removal of tissue expander(s) without insertion of prosthesis<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 12007 – Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and\/or extremities (including hands and feet); over 30.0 cm<\/td>\n<\/tr>\n | 12011 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 2.5 cm or less<\/td>\n<\/tr>\n | 12013 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 2.6 cm to 5.0 cm<\/td>\n<\/tr>\n | 12014 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 5.1 cm to 7.5 cm<\/td>\n<\/tr>\n | 12015 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 7.6 cm to 12.5 cm<\/td>\n<\/tr>\n | 12016 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 12.6 cm to 20.0 cm<\/td>\n<\/tr>\n | 12017 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 20.1 cm to 30.0 cm<\/td>\n<\/tr>\n | 12018 – Simple repair of superficial wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; over 30.0 cm<\/td>\n<\/tr>\n | 12020 – Treatment of superficial wound dehiscence; simple closure<\/td>\n<\/tr>\n | 12021 – Treatment of superficial wound dehiscence; with packing<\/td>\n<\/tr>\n | 12031 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); 2.5 cm or less<\/td>\n<\/tr>\n | 12032 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm<\/td>\n<\/tr>\n | 12034 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm<\/td>\n<\/tr>\n | 12035 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm<\/td>\n<\/tr>\n | 12036 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm<\/td>\n<\/tr>\n | 12037 – Repair, intermediate, wounds of scalp, axillae, trunk and\/or extremities (excluding hands and feet); over 30.0 cm<\/td>\n<\/tr>\n | 12041 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; 2.5 cm or less<\/td>\n<\/tr>\n | 12042 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; 2.6 cm to 7.5 cm<\/td>\n<\/tr>\n | 12044 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; 7.6 cm to 12.5 cm<\/td>\n<\/tr>\n | 12045 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; 12.6 cm to 20.0 cm<\/td>\n<\/tr>\n | 12046 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; 20.1 cm to 30.0 cm<\/td>\n<\/tr>\n | 12047 – Repair, intermediate, wounds of neck, hands, feet and\/or external genitalia; over 30.0 cm<\/td>\n<\/tr>\n | 12051 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 2.5 cm or less<\/td>\n<\/tr>\n | 12052 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 2.6 cm to 5.0 cm<\/td>\n<\/tr>\n | 12053 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 5.1 cm to 7.5 cm<\/td>\n<\/tr>\n | 12054 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 7.6 cm to 12.5 cm<\/td>\n<\/tr>\n | 12055 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 12.6 cm to 20.0 cm<\/td>\n<\/tr>\n | 12056 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; 20.1 cm to 30.0 cm<\/td>\n<\/tr>\n | 12057 – Repair, intermediate, wounds of face, ears, eyelids, nose, lips and\/or mucous membranes; over 30.0 cm<\/td>\n<\/tr>\n | 13120 – Repair, complex, scalp, arms, and\/or legs; 1.1 cm to 2.5 cm<\/td>\n<\/tr>\n | 13121 – Repair, complex, scalp, arms, and\/or legs; 2.6 cm to 7.5 cm<\/td>\n<\/tr>\n | 13122 – Repair, complex, scalp, arms, and\/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 13131 – Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and\/or feet; 1.1 cm to 2.5 cm<\/td>\n<\/tr>\n | 13132 – Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and\/or feet; 2.6 cm to 7.5 cm<\/td>\n<\/tr>\n | 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)<\/td>\n<\/tr>\n | 13151 – Repair, complex, eyelids, nose, ears and\/or lips; 1.1 cm to 2.5 cm<\/td>\n<\/tr>\n | 13152 – Repair, complex, eyelids, nose, ears and\/or lips; 2.6 cm to 7.5 cm<\/td>\n<\/tr>\n | 13153 – Repair, complex, eyelids, nose, ears and\/or lips; each additional 5 cm or less (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 13160 – Secondary closure of surgical wound or dehiscence, extensive or complicated<\/td>\n<\/tr>\n | 14020 – Adjacent tissue transfer or rearrangement, scalp, arms and\/or legs; defect 10 sq cm or less<\/td>\n<\/tr>\n | 14021 – Adjacent tissue transfer or rearrangement, scalp, arms and\/or legs; defect 10.1 sq cm to 30.0 sq cm<\/td>\n<\/tr>\n | 14040 – Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and\/or feet; defect 10 sq cm or less<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 14060 – Adjacent tissue transfer or rearrangement, eyelids, nose, ears and\/or lips; defect 10 sq cm or less<\/td>\n<\/tr>\n | 14061 – Adjacent tissue transfer or rearrangement, eyelids, nose, ears and\/or lips; defect 10.1 sq cm to 30.0 sq cm<\/td>\n<\/tr>\n | 14301 – Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm<\/td>\n<\/tr>\n | 14302 – Adjacent tissue transfer or rearrangement, any area; each additional 30.0 sq cm, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 14350 – Filleted finger or toe flap, including preparation of recipient site<\/td>\n<\/tr>\n | 15040 – Harvest of skin for tissue cultured skin aurograft, 100 sq cm or less<\/td>\n<\/tr>\n | 15100 – Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1 percent of body area of infants and children (except 15050)<\/td>\n<\/tr>\n | 15101 – Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1 percent of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 15110 – Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1 percent of body area of infants and children<\/td>\n<\/tr>\n | 15111 – Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1 percent of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 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 percent of body area of infants and children<\/td>\n<\/tr>\n | 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 percent of body area of infants and children, or part thereof (List separately)<\/td>\n<\/tr>\n | 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 percent of body area of infants and children (except 15050)<\/td>\n<\/tr>\n | 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 percent of body area of infants and children, or part thereof (List)<\/td>\n<\/tr>\n | 15130 – Dermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1 percent of body area of infants and children<\/td>\n<\/tr>\n | 15131 – Dermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1 percent of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 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 percent of body area of infants and children<\/td>\n<\/tr>\n | 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 percent of body area of infants and children, or part thereof (List separately)<\/td>\n<\/tr>\n | 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)<\/td>\n<\/tr>\n | 15157 – Tissue cultured skin autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and\/or multiple digits; each additional 100 sq cm, or each additional 1 percent of body area of infants and children, or part thereof (List)<\/td>\n<\/tr>\n | 15200 – Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less<\/td>\n<\/tr>\n | 15201 – Full thickness graft, free, including direct closure of donor site, trunk; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 15220 – Full thickness graft, free, including direct closure of donor site, scalp, arms, and\/or legs; 20 sq cm or less<\/td>\n<\/tr>\n | 15221 – Full thickness graft, free, including direct closure of donor site, scalp, arms, and\/or legs; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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)<\/td>\n<\/tr>\n | 15260 – Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and\/or lips; 20 sq cm or less<\/td>\n<\/tr>\n | 15261 – Full thickness graft, free, including direct closure of donor site, nose, ears, eyelids, and\/or lips; each additional 20 sq cm, or part thereof (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 15271 – Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area<\/td>\n<\/tr>\n | 15272 – Application of skin substitute graft to trunk, arms, legs, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof ( list separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 15273 – Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children<\/td>\n<\/tr>\n | 15274 – Application of skin sub. graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; each add. 100 sq cm wound surface area, or part thereof, or each addt’l 1% area of infants and children, or part thereof (separa<\/td>\n<\/tr>\n | 15275 – Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and\/or multiple digits, total wound surface area up to 100 sq cm; first 25 sq cm or less wound surface area<\/td>\n<\/tr>\n | 15276 – Application of skin substitute graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and\/or multiple digits, total wound surface area up to 100 sq cm; each additional 25 sq cm wound surface area, or part thereof (List)<\/td>\n<\/tr>\n | 15277 – App. of skin sub. graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and\/or multiple digits, total wound surface area = 100 sq cm; first 100 sq cm wound surface area, or 1 percent of body area of infants and children<\/td>\n<\/tr>\n | 15278 – App. of skin sub. graft to face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and\/or multiple digits, total wound surface area = 100 sq cm; List each additional percent of body area in addition to code for primary procedure<\/td>\n<\/tr>\n | 15570 – Formation of direct or tubed pedicle, with or without transfer; trunk<\/td>\n<\/tr>\n | 15572 – Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs<\/td>\n<\/tr>\n | 15574 – Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet<\/td>\n<\/tr>\n | 15576 – Formation of direct or tubed pedicle, with or without transfer; eyelids, nose, ears, lips, or intraoral<\/td>\n<\/tr>\n | 15600 – Delay of flap or sectioning of flap (division and inset); at trunk<\/td>\n<\/tr>\n | 15610 – Delay of flap or sectioning of flap (division and inset); at scalp, arms, or legs<\/td>\n<\/tr>\n | 15620 – Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet<\/td>\n<\/tr>\n | 15630 – Delay of flap or sectioning of flap (division and inset); at eyelids, nose, ears, or lips<\/td>\n<\/tr>\n | 15650 – Transfer, intermediate, of any pedicle flap (eg, abdomen to wrist, Walking tube), any location<\/td>\n<\/tr>\n | 15731 – Forehead flap with preservation of vascular pedicle (eg, axial pattern flap, paramedian forehead flap)<\/td>\n<\/tr>\n | 15732 – Muscle, myocutaneous, or fasciocutaneous flap; head and neck (eg, temporalis, masseter muscle, sternocleidomastoid, levator scapulae)<\/td>\n<\/tr>\n | 15734 – Muscle, myocutaneous, or fasciocutaneous flap; trunk<\/td>\n<\/tr>\n | 15740 – Flap; island pedicle requiring identification and dissection of an anatomically named axial vessel<\/td>\n<\/tr>\n | 15750 – Flap; neurovascular pedicle<\/td>\n<\/tr>\n | 15756 – Free muscle or myocutaneous flap with microvascular anastomosis<\/td>\n<\/tr>\n | 15757 – Free skin flap with microvascular anastomosis<\/td>\n<\/tr>\n | 15758 – Free fascial flap with microvascular anastomosis<\/td>\n<\/tr>\n | 15760 – Graft; composite (eg, full thickness of external ear or nasal ala), including primary closure, donor area<\/td>\n<\/tr>\n | 15770 – Graft; derma-fat-fascia<\/td>\n<\/tr>\n | 15775 – Punch graft for hair transplant; 1 to 15 punch grafts<\/td>\n<\/tr>\n | 15776 – Punch graft for hair transplant; more than 15 punch grafts<\/td>\n<\/tr>\n | 15780 – Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)<\/td>\n<\/tr>\n | 15781 – Dermabrasion; segmental, face<\/td>\n<\/tr>\n | 15782 – Dermabrasion; regional, other than face<\/td>\n<\/tr>\n | 15783 – Dermabrasion; superficial, any site (eg, tattoo removal)<\/td>\n<\/tr>\n | 15786 – Abrasion; single lesion (eg, keratosis, scar)<\/td>\n<\/tr>\n | 15787 – Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 15788 – Chemical peel, facial; epidermal<\/td>\n<\/tr>\n | 15789 – Chemical peel, facial; dermal<\/td>\n<\/tr>\n | 15792 – Chemical peel, nonfacial; epidermal<\/td>\n<\/tr>\n | 15793 – Chemical peel, nonfacial; dermal<\/td>\n<\/tr>\n | 15819 – Cervicoplasty<\/td>\n<\/tr>\n | 15820 – Blepharoplasty, lower eyelid;<\/td>\n<\/tr>\n | 15821 – Blepharoplasty, lower eyelid; with extensive herniated fat pad<\/td>\n<\/tr>\n | 15822 – Blepharoplasty, upper eyelid;<\/td>\n<\/tr>\n | 15823 – Blepharoplasty, upper eyelid; with excessive skin weighting down lid<\/td>\n<\/tr>\n | 15824 – Rhytidectomy; forehead<\/td>\n<\/tr>\n | 15825 – Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)<\/td>\n<\/tr>\n | 15826 – Rhytidectomy; glabellar frown lines<\/td>\n<\/tr>\n | 15828 – Rhytidectomy; cheek, chin, and neck<\/td>\n<\/tr>\n | 15829 – Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap<\/td>\n<\/tr>\n | 15838 – Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad<\/td>\n<\/tr>\n | 15840 – Graft for facial nerve paralysis; free fascia graft (including obtaining fascia)<\/td>\n<\/tr>\n | 15841 – Graft for facial nerve paralysis; free muscle graft (including obtaining graft)<\/td>\n<\/tr>\n | 15842 – Graft for facial nerve paralysis; free muscle flap by microsurgical technique<\/td>\n<\/tr>\n | 15845 – Graft for facial nerve paralysis; regional muscle transfer<\/td>\n<\/tr>\n | 15850 – Removal of sutures under anesthesia (other than local), same surgeon<\/td>\n<\/tr>\n | 15876 – Suction assisted lipectomy; head and neck<\/td>\n<\/tr>\n | 17000 – Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); first lesion<\/td>\n<\/tr>\n | 17003 – Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses); second through 14 lesions, each (List separately in addition to code for first lesion)<\/td>\n<\/tr>\n | 17004 – Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions<\/td>\n<\/tr>\n | 17106 – Destruction of cutaneous vascular proliferative lesions (eg, laser technique); less than 10 sq cm<\/td>\n<\/tr>\n | 17107 – Destruction of cutaneous vascular proliferative lesions (eg, laser technique); 10.0 to 50.0 sq cm<\/td>\n<\/tr>\n | 17108 – Destruction of cutaneous vascular proliferative lesions (eg, laser technique); over 50.0 sq cm<\/td>\n<\/tr>\n | 17110 – Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; up to 14 lesions<\/td>\n<\/tr>\n | 17111 – Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), of benign lesions other than skin tags or cutaneous vascular proliferative lesions; 15 or more lesions<\/td>\n<\/tr>\n | 17250 – Chemical cauterization of granulation tissue (proud flesh, sinus or fistula)<\/td>\n<\/tr>\n | 17270 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter 0.5 cm or less<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 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<\/td>\n<\/tr>\n | 17276 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), scalp, neck, hands, feet, genitalia; lesion diameter over 4.0 cm<\/td>\n<\/tr>\n | 17280 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.5 cm or less<\/td>\n<\/tr>\n | 17281 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 0.6 to 1.0 cm<\/td>\n<\/tr>\n | 17282 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 1.1 to 2.0 cm<\/td>\n<\/tr>\n | 17283 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 2.1 to 3.0 cm<\/td>\n<\/tr>\n | 17284 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter 3.1 to 4.0 cm<\/td>\n<\/tr>\n | 17286 – Destruction, malignant lesion (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), face, ears, eyelids, nose, lips, mucous membrane; lesion diameter over 4.0 cm<\/td>\n<\/tr>\n | 20005 – Incision and drainage of soft tissue abscess, subfascial (ie, involves the soft tissue below the deep fascia)<\/td>\n<\/tr>\n | 20205 – Biopsy, muscle; deep<\/td>\n<\/tr>\n | 20220 – Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs<\/td>\n<\/tr>\n | 20220 – Biopsy, bone, trocar, or needle; superficial (eg, ilium, sternum, spinous process, ribs)<\/td>\n<\/tr>\n | 20225 – Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)<\/td>\n<\/tr>\n | 20225 – Biopsy, bone, trocar, or needle; deep (eg, vertebral body, femur)<\/td>\n<\/tr>\n | 20240 – Biopsy, bone, open; superficial (eg, ilium, sternum, spinous process, ribs, trochanter of femur)<\/td>\n<\/tr>\n | 20245 – Biopsy, bone, open; deep (eg, humerus, ischium, femur)<\/td>\n<\/tr>\n | 20520 – Removal of foreign body in muscle or tendon sheath; simple<\/td>\n<\/tr>\n | 20525 – Removal of foreign body in muscle or tendon sheath; deep or complicated<\/td>\n<\/tr>\n | 20600 – Arthrocentesis, aspiration and\/or injection, small joint or bursa (eg, fingers, toes); without ultrasound guidance<\/td>\n<\/tr>\n | 20605 – Arthrocentesis, aspiration and\/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); without ultrasound guidance<\/td>\n<\/tr>\n | 20606 – Arthrocentesis, aspiration and\/or injection, intermediate joint or bursa (eg, temporomandibular, acromioclavicular, wrist, elbow or ankle, olecranon bursa); with ultrasound guidance, with permanent recording and reporting<\/td>\n<\/tr>\n | 20615 – Aspiration and injection for treatment of bone cyst<\/td>\n<\/tr>\n | 20650 – Insertion of wire or pin with application of skeletal traction, including removal (separate procedure)<\/td>\n<\/tr>\n | 20670 – Removal of implant; superficial (eg, buried wire, pin or rod) (separate procedure)<\/td>\n<\/tr>\n | 20680 – Removal of implant; deep (eg, buried wire, pin, screw, metal band, nail, rod or plate)<\/td>\n<\/tr>\n | 20690 – Application of a uniplane (pins or wires in 1 plane), unilateral, external fixation system<\/td>\n<\/tr>\n | 20692 – Application of a multiplane (pins or wires in more than 1 plane), unilateral, external fixation system (eg, Ilizarov, Monticelli type)<\/td>\n<\/tr>\n | 20693 – Adjustment or revision of external fixation system requiring anesthesia (eg, new pin[s] or wire[s] and\/or new ring[s] or bar[s])<\/td>\n<\/tr>\n | 20694 – Removal, under anesthesia, of external fixation system<\/td>\n<\/tr>\n | 20696 – Application of multiplane (pins or wires in more than 1 plane), unilateral, ext. fixation with stereotactic computer-assisted adjustment, including imaging; initial and subs. alignment(s), assessment(s), and computation(s) of adjustment schedule(s)<\/td>\n<\/tr>\n | 20900 – Bone graft, any donor area; minor or small (eg, dowel or button)<\/td>\n<\/tr>\n | 20902 – Bone graft, any donor area; major or large<\/td>\n<\/tr>\n | 20910 – Cartilage graft; costochondral<\/td>\n<\/tr>\n | 20912 – Cartilage graft; nasal septum<\/td>\n<\/tr>\n | 20920 – Fascia lata graft; by stripper<\/td>\n<\/tr>\n | 20922 – Fascia lata graft; by incision and area exposure, complex or sheet<\/td>\n<\/tr>\n | 20926 – Tissue grafts, other (eg, paratenon, fat, dermis)<\/td>\n<\/tr>\n | 20955 – Bone graft with microvascular anastomosis; fibula<\/td>\n<\/tr>\n | 20956 – Bone graft with microvascular anastomosis; iliac crest<\/td>\n<\/tr>\n | 20957 – Bone graft with microvascular anastomosis; metatarsal<\/td>\n<\/tr>\n | 20962 – Bone graft with microvascular anastomosis; other than fibula, iliac crest, or metatarsal<\/td>\n<\/tr>\n | 20969 – Free osteocutaneous flap with microvascular anastomosis; other than iliac crest, metatarsal, or great toe<\/td>\n<\/tr>\n | 20970 – Free osteocutaneous flap with microvascular anastomosis; iliac crest<\/td>\n<\/tr>\n | 20972 – Free osteocutaneous flap with microvascular anastomosis; metatarsal<\/td>\n<\/tr>\n | 20973 – Free osteocutaneous flap with microvascular anastomosis; great toe with web space<\/td>\n<\/tr>\n | 20999 – Unlisted procedure, musculoskeletal system, general<\/td>\n<\/tr>\n | 21010 – Arthrotomy, temporomandibular joint<\/td>\n<\/tr>\n | 21011 – Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm<\/td>\n<\/tr>\n | 21012 – Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater<\/td>\n<\/tr>\n | 21013 – Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); less than 2 cm<\/td>\n<\/tr>\n | 21014 – Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater<\/td>\n<\/tr>\n | 21015 – Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; less than 2 cm<\/td>\n<\/tr>\n | 21016 – Radical resection of tumor (eg, sarcoma), soft tissue of face or scalp; 2 cm or greater<\/td>\n<\/tr>\n | 21025 – Excision of bone (eg, for osteomyelitis or bone abscess); mandible<\/td>\n<\/tr>\n | 21026 – Excision of bone (eg, for osteomyelitis or bone abscess); facial bone(s)<\/td>\n<\/tr>\n | 21029 – Removal by contouring of benign tumor of facial bone (eg, fibrous dysplasia)<\/td>\n<\/tr>\n | 21030 – Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage<\/td>\n<\/tr>\n | 21031 – Excision of torus mandibularis<\/td>\n<\/tr>\n | 21032 – Excision of maxillary torus palatinus<\/td>\n<\/tr>\n | 21034 – Excision of malignant tumor of maxilla or zygoma<\/td>\n<\/tr>\n | 21040 – Excision of benign tumor or cyst of mandible, by enucleation and\/or curettage<\/td>\n<\/tr>\n | 21044 – Excision of malignant tumor of mandible;<\/td>\n<\/tr>\n | 21045 – Excision of malignant tumor of mandible; radical resection<\/td>\n<\/tr>\n | 21046 – Excision of benign tumor or cyst of mandible; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])<\/td>\n<\/tr>\n | 21047 – Excision of benign tumor or cyst of mandible; requiring extra-oral osteotomy and partial mandibulectomy (eg, locally aggressive or destructive lesion[s])<\/td>\n<\/tr>\n | 21048 – Excision of benign tumor or cyst of maxilla; requiring intra-oral osteotomy (eg, locally aggressive or destructive lesion[s])<\/td>\n<\/tr>\n | 21049 – Excision of benign tumor or cyst of maxilla; requiring extra-oral osteotomy and partial maxillectomy (eg, locally aggressive or destructive lesion[s])<\/td>\n<\/tr>\n | 21050 – Condylectomy, temporomandibular joint (separate procedure)<\/td>\n<\/tr>\n | 21060 – Meniscectomy, partial or complete, temporomandibular joint (separate procedure)<\/td>\n<\/tr>\n | 21070 – Coronoidectomy (separate procedure)<\/td>\n<\/tr>\n | 21073 – Manipulation of temporomandibular joint(s) (TMJ), therapeutic, requiring an anesthesia service (ie, general or monitored anesthesia care)<\/td>\n<\/tr>\n | 21085 – Impression and custom preparation; oral surgical splint<\/td>\n<\/tr>\n | 21100 – Application of halo type appliance for maxillofacial fixation, includes removal (separate procedure)<\/td>\n<\/tr>\n | 21110 – Application of interdental fixation device for conditions other than fracture or dislocation, includes removal<\/td>\n<\/tr>\n | 21116 – Injection procedure for temporomandibular joint arthrography<\/td>\n<\/tr>\n | 21120 – Genioplasty; augmentation (autograft, allograft, prosthetic material)<\/td>\n<\/tr>\n | 21121 – Genioplasty; sliding osteotomy, single piece<\/td>\n<\/tr>\n | 21122 – Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)<\/td>\n<\/tr>\n | 21123 – Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21125 – Augmentation, mandibular body or angle; prosthetic material<\/td>\n<\/tr>\n | 21127 – Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)<\/td>\n<\/tr>\n | 21137 – Reduction forehead; contouring only<\/td>\n<\/tr>\n | 21138 – Reduction forehead; contouring and application of prosthetic material or bone graft (includes obtaining autograft)<\/td>\n<\/tr>\n | 21139 – Reduction forehead; contouring and setback of anterior frontal sinus wall<\/td>\n<\/tr>\n | 21141 – Reconstruction midface, LeFort I; single piece, segment movement in any direction (eg, for Long Face Syndrome), without bone graft<\/td>\n<\/tr>\n | 21142 – Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, without bone graft<\/td>\n<\/tr>\n | 21143 – Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, without bone graft<\/td>\n<\/tr>\n | 21145 – Reconstruction midface, LeFort I; single piece, segment movement in any direction, requiring bone grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21146 – Reconstruction midface, LeFort I; 2 pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted unilateral alveolar cleft)<\/td>\n<\/tr>\n | 21147 – Reconstruction midface, LeFort I; 3 or more pieces, segment movement in any direction, requiring bone grafts (includes obtaining autografts) (eg, ungrafted bilateral alveolar cleft or multiple osteotomies)<\/td>\n<\/tr>\n | 21150 – Reconstruction midface, LeFort II; anterior intrusion (eg, Treacher-Collins Syndrome)<\/td>\n<\/tr>\n | 21151 – Reconstruction midface, LeFort II; any direction, requiring bone grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21154 – Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); without LeFort I<\/td>\n<\/tr>\n | 21155 – Reconstruction midface, LeFort III (extracranial), any type, requiring bone grafts (includes obtaining autografts); with LeFort I<\/td>\n<\/tr>\n | 21159 – Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); without LeFort I<\/td>\n<\/tr>\n | 21160 – Reconstruction midface, LeFort III (extra and intracranial) with forehead advancement (eg, mono bloc), requiring bone grafts (includes obtaining autografts); with LeFort I<\/td>\n<\/tr>\n | 21172 – Reconstruction superior-lateral orbital rim and lower forehead, advancement or alteration, with or without grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21175 – Reconstruction, bifrontal, superior-lateral orbital rims and lower forehead, advancement or alteration (eg, plagiocephaly, trigonocephaly, brachycephaly), with or without grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21179 – Reconstruction, entire or majority of forehead and\/or supraorbital rims; with grafts (allograft or prosthetic material)<\/td>\n<\/tr>\n | 21180 – Reconstruction, entire or majority of forehead and\/or supraorbital rims; with autograft (includes obtaining grafts)<\/td>\n<\/tr>\n | 21181 – Reconstruction by contouring of benign tumor of cranial bones (eg, fibrous dysplasia), extracranial<\/td>\n<\/tr>\n | 21182 – Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone, with multiple autografts (includes obtaining grafts); total area of bone grafting less than 40 sq cm<\/td>\n<\/tr>\n | 21183 – Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone, with multiple autografts (includes obtaining grafts); total area of bone grafting >40 sq cm, <80 sq cm<\/td>\n<\/tr>\n | 21184 – Reconstruction of orbital walls, rims, forehead, nasoethmoid complex following intra- and extracranial excision of benign tumor of cranial bone, with multiple autografts (includes obtaining grafts); total area of bone grafting >80 sq cm<\/td>\n<\/tr>\n | 21188 – Reconstruction midface, osteotomies (other than LeFort type) and bone grafts (includes obtaining autografts)<\/td>\n<\/tr>\n | 21193 – Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; without bone graft<\/td>\n<\/tr>\n | 21194 – Reconstruction of mandibular rami, horizontal, vertical, C, or L osteotomy; with bone graft (includes obtaining graft)<\/td>\n<\/tr>\n | 21195 – Reconstruction of mandibular rami and\/or body, sagittal split; without internal rigid fixation<\/td>\n<\/tr>\n | 21196 – Reconstruction of mandibular rami and\/or body, sagittal split; with internal rigid fixation<\/td>\n<\/tr>\n | 21198 – Osteotomy, mandible, segmental;<\/td>\n<\/tr>\n | 21199 – Osteotomy, mandible, segmental; with genioglossus advancement<\/td>\n<\/tr>\n | 21206 – Osteotomy, maxilla, segmental (eg, Wassmund or Schuchard)<\/td>\n<\/tr>\n | 21208 – Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)<\/td>\n<\/tr>\n | 21209 – Osteoplasty, facial bones; reduction<\/td>\n<\/tr>\n | 21210 – Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)<\/td>\n<\/tr>\n | 21215 – Graft, bone; mandible (includes obtaining graft)<\/td>\n<\/tr>\n | 21230 – Graft; rib cartilage, autogenous, to face, chin, nose or ear (includes obtaining graft)<\/td>\n<\/tr>\n | 21235 – Graft; ear cartilage, autogenous, to nose or ear (includes obtaining graft)<\/td>\n<\/tr>\n | 21240 – Arthroplasty, temporomandibular joint, with or without autograft (includes obtaining graft)<\/td>\n<\/tr>\n | 21242 – Arthroplasty, temporomandibular joint, with allograft<\/td>\n<\/tr>\n | 21243 – Arthroplasty, temporomandibular joint, with prosthetic joint replacement<\/td>\n<\/tr>\n | 21244 – Reconstruction of mandible, extraoral, with transosteal bone plate (eg, mandibular staple bone plate)<\/td>\n<\/tr>\n | 21245 – Reconstruction of mandible or maxilla, subperiosteal implant; partial<\/td>\n<\/tr>\n | 21246 – Reconstruction of mandible or maxilla, subperiosteal implant; complete<\/td>\n<\/tr>\n | 21247 – Reconstruction of mandibular condyle with bone and cartilage autografts (includes obtaining grafts) (eg, for hemifacial microsomia)<\/td>\n<\/tr>\n | 21248 – Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); partial<\/td>\n<\/tr>\n | 21249 – Reconstruction of mandible or maxilla, endosteal implant (eg, blade, cylinder); complete<\/td>\n<\/tr>\n | 21255 – Reconstruction of zygomatic arch and glenoid fossa with bone and cartilage (includes obtaining autografts)<\/td>\n<\/tr>\n | 21256 – Reconstruction of orbit with osteotomies (extracranial) and with bone grafts (includes obtaining autografts) (eg, micro-ophthalmia)<\/td>\n<\/tr>\n | 21260 – Periorbital osteotomies for orbital hypertelorism, with bone grafts; extracranial approach<\/td>\n<\/tr>\n | 21261 – Periorbital osteotomies for orbital hypertelorism, with bone grafts; combined intra- and extracranial approach<\/td>\n<\/tr>\n | 21263 – Periorbital osteotomies for orbital hypertelorism, with bone grafts; with forehead advancement<\/td>\n<\/tr>\n | 21267 – Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; extracranial approach<\/td>\n<\/tr>\n | 21268 – Orbital repositioning, periorbital osteotomies, unilateral, with bone grafts; combined intra- and extracranial approach<\/td>\n<\/tr>\n | 21270 – Malar augmentation, prosthetic material<\/td>\n<\/tr>\n | 21275 – Secondary revision of orbitocraniofacial reconstruction<\/td>\n<\/tr>\n | 21280 – Medial canthopexy (separate procedure)<\/td>\n<\/tr>\n | 21282 – Lateral canthopexy<\/td>\n<\/tr>\n | 21295 – Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); extraoral approach<\/td>\n<\/tr>\n | 21296 – Reduction of masseter muscle and bone (eg, for treatment of benign masseteric hypertrophy); intraoral approach<\/td>\n<\/tr>\n | 21310 – Closed treatment of nasal bone fracture without manipulation<\/td>\n<\/tr>\n | 21315 – Closed treatment of nasal bone fracture; without stabilization<\/td>\n<\/tr>\n | 21320 – Closed treatment of nasal bone fracture; with stabilization<\/td>\n<\/tr>\n | 21325 – Open treatment of nasal fracture; uncomplicated<\/td>\n<\/tr>\n | 21330 – Open treatment of nasal fracture; complicated, with internal and\/or external skeletal fixation<\/td>\n<\/tr>\n | 21335 – Open treatment of nasal fracture; with concomitant open treatment of fractured septum<\/td>\n<\/tr>\n | 21336 – Open treatment of nasal septal fracture, with or without stabilization<\/td>\n<\/tr>\n | 21337 – Closed treatment of nasal septal fracture, with or without stabilization<\/td>\n<\/tr>\n | 21338 – Open treatment of nasoethmoid fracture; without external fixation<\/td>\n<\/tr>\n | 21339 – Open treatment of nasoethmoid fracture; with external fixation<\/td>\n<\/tr>\n | 21340 – Percutaneous treatment of nasoethmoid complex fracture, with splint, wire or headcap fixation, including repair of canthal ligaments and\/or the nasolacrimal apparatus<\/td>\n<\/tr>\n | 21343 – Open treatment of depressed frontal sinus fracture<\/td>\n<\/tr>\n | 21344 – Open treatment of complicated (eg, comminuted or involving posterior wall) frontal sinus fracture, via coronal or multiple approaches<\/td>\n<\/tr>\n | 21345 – Closed treatment of nasomaxillary complex fracture (LeFort II type), with interdental wire fixation or fixation of denture or splint<\/td>\n<\/tr>\n | 21346 – Open treatment of nasomaxillary complex fracture (LeFort II type); with wiring and\/or local fixation<\/td>\n<\/tr>\n | 21347 – Open treatment of nasomaxillary complex fracture (LeFort II type); requiring multiple open approaches<\/td>\n<\/tr>\n | 21348 – Open treatment of nasomaxillary complex fracture (LeFort II type); with bone grafting (includes obtaining graft)<\/td>\n<\/tr>\n | 21355 – Percutaneous treatment of fracture of malar area, including zygomatic arch and malar tripod, with manipulation<\/td>\n<\/tr>\n | 21356 – Open treatment of depressed zygomatic arch fracture (eg, Gillies approach)<\/td>\n<\/tr>\n | 21360 – Open treatment of depressed malar fracture, including zygomatic arch and malar tripod<\/td>\n<\/tr>\n | 21365 – Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with internal fixation and multiple surgical approaches<\/td>\n<\/tr>\n | 21366 – Open treatment of complicated (eg, comminuted or involving cranial nerve foramina) fracture(s) of malar area, including zygomatic arch and malar tripod; with bone grafting (includes obtaining graft)<\/td>\n<\/tr>\n | 21385 – Open treatment of orbital floor blowout fracture; transantral approach (Caldwell-Luc type operation)<\/td>\n<\/tr>\n | 21386 – Open treatment of orbital floor blowout fracture; periorbital approach<\/td>\n<\/tr>\n | 21387 – Open treatment of orbital floor blowout fracture; combined approach<\/td>\n<\/tr>\n | 21390 – Open treatment of orbital floor blowout fracture; periorbital approach, with alloplastic or other implant<\/td>\n<\/tr>\n | 21395 – Open treatment of orbital floor blowout fracture; periorbital approach with bone graft (includes obtaining graft)<\/td>\n<\/tr>\n | 21400 – Closed treatment of fracture of orbit, except blowout; without manipulation<\/td>\n<\/tr>\n | 21401 – Closed treatment of fracture of orbit, except blowout; with manipulation<\/td>\n<\/tr>\n | 21406 – Open treatment of fracture of orbit, except blowout; without implant<\/td>\n<\/tr>\n | 21407 – Open treatment of fracture of orbit, except blowout; with implant<\/td>\n<\/tr>\n | 21408 – Open treatment of fracture of orbit, except blowout; with bone grafting (includes obtaining graft)<\/td>\n<\/tr>\n | 21421 – Closed treatment of palatal or maxillary fracture (LeFort I type), with interdental wire fixation or fixation of denture or splint<\/td>\n<\/tr>\n | 21422 – Open treatment of palatal or maxillary fracture (LeFort I type);<\/td>\n<\/tr>\n | 21423 – Open treatment of palatal or maxillary fracture (LeFort I type); complicated (comminuted or involving cranial nerve foramina), multiple approaches<\/td>\n<\/tr>\n | 21431 – Closed treatment of craniofacial separation (LeFort III type) using interdental wire fixation of denture or splint<\/td>\n<\/tr>\n | 21432 – Open treatment of craniofacial separation (LeFort III type); with wiring and\/or internal fixation<\/td>\n<\/tr>\n | 21433 – Open treatment of craniofacial separation (LeFort III type); complicated (eg, comminuted or involving cranial nerve foramina), multiple surgical approaches<\/td>\n<\/tr>\n | 21435 – Open treatment of craniofacial separation (LeFort III type); complicated, utilizing internal and\/or external fixation techniques (eg, head cap, halo device, and\/or intermaxillary fixation)<\/td>\n<\/tr>\n | 21436 – Open treatment of craniofacial separation (LeFort III type); complicated, multiple surgical approaches, internal fixation, with bone grafting (includes obtaining graft)<\/td>\n<\/tr>\n | 21440 – Closed treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)<\/td>\n<\/tr>\n | 21445 – Open treatment of mandibular or maxillary alveolar ridge fracture (separate procedure)<\/td>\n<\/tr>\n | 21450 – Closed treatment of mandibular fracture; without manipulation<\/td>\n<\/tr>\n | 21451 – Closed treatment of mandibular fracture; with manipulation<\/td>\n<\/tr>\n | 21452 – Percutaneous treatment of mandibular fracture, with external fixation<\/td>\n<\/tr>\n | 21453 – Closed treatment of mandibular fracture with interdental fixation<\/td>\n<\/tr>\n | 21454 – Open treatment of mandibular fracture with external fixation<\/td>\n<\/tr>\n | 21461 – Open treatment of mandibular fracture; without interdental fixation<\/td>\n<\/tr>\n | 21462 – Open treatment of mandibular fracture; with interdental fixation<\/td>\n<\/tr>\n | 21465 – Open treatment of mandibular condylar fracture<\/td>\n<\/tr>\n | 21470 – Open treatment of complicated mandibular fracture by multiple surgical approaches including internal fixation, interdental fixation, and\/or wiring of dentures or splints<\/td>\n<\/tr>\n | 21480 – Closed treatment of temporomandibular dislocation; initial or subsequent<\/td>\n<\/tr>\n | 21485 – Closed treatment of temporomandibular dislocation; initial or subsequent; complicated (eg, recurrent requiring intermaxiallary fixation or splinting), initial or subsequent<\/td>\n<\/tr>\n | 21490 – Open treatment of temporomandibular dislocation<\/td>\n<\/tr>\n | 21495 – Open treatment of hyoid fracture<\/td>\n<\/tr>\n | 21497 – Interdental wiring, for condition other than fracture<\/td>\n<\/tr>\n | 21501 – Incision and drainage, deep abscess or hematoma, soft tissues of neck or thorax;<\/td>\n<\/tr>\n | 21550 – Biopsy, soft tissue of neck or thorax<\/td>\n<\/tr>\n | 21552 – Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater<\/td>\n<\/tr>\n | 21554 – Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater<\/td>\n<\/tr>\n | 21555 – Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm<\/td>\n<\/tr>\n | 21556 – Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm<\/td>\n<\/tr>\n | 21557 – Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; less than 5 cm<\/td>\n<\/tr>\n | 21558 – Radical resection of tumor (eg, sarcoma), soft tissue of neck or anterior thorax; 5 cm or greater<\/td>\n<\/tr>\n | 29800 – Arthroscopy, temporomandibular joint, diagnostic, with or without synovial biopsy (separate procedure)<\/td>\n<\/tr>\n | 29804 – Arthroscopy, temporomandibular joint, surgical<\/td>\n<\/tr>\n | 30000 – Drainage abscess or hematoma, nasal, internal approach<\/td>\n<\/tr>\n | 30020 – Drainage abscess or hematoma, nasal septum<\/td>\n<\/tr>\n | 30020 – Drainage abscess or hematoma, nasal septum<\/td>\n<\/tr>\n | 30100 – Biopsy, intranasal<\/td>\n<\/tr>\n | 30110 – Excision, nasal polyp(s), simple<\/td>\n<\/tr>\n | 30115 – Excision, nasal polyp(s), extensive<\/td>\n<\/tr>\n | 30117 – Excision or destruction (eg, laser), intranasal lesion; internal approach<\/td>\n<\/tr>\n | 30118 – Excision or destruction (eg, laser), intranasal lesion; external approach (lateral rhinotomy)<\/td>\n<\/tr>\n | 30120 – Excision or surgical planing of skin of nose for rhinophyma<\/td>\n<\/tr>\n | 30124 – Excision dermoid cyst, nose; simple, skin, subcutaneous<\/td>\n<\/tr>\n | 30125 – Excision dermoid cyst, nose; complex, under bone or cartilage<\/td>\n<\/tr>\n | 30130 – Excision inferior turbinate, partial or complete, any method<\/td>\n<\/tr>\n | 30140 – Submucous resection inferior turbinate, partial or complete, any method<\/td>\n<\/tr>\n | 30150 – Rhinectomy; partial<\/td>\n<\/tr>\n | 30160 – Rhinectomy; total<\/td>\n<\/tr>\n | 30310 – Removal foreign body, intranasal; office type procedure, requiring general anesthesia<\/td>\n<\/tr>\n | 30320 – Removal foreign body, intranasal; office type procedure, requiring general anesthesia; by lateral rhinotomy<\/td>\n<\/tr>\n | 30400 – Rhinoplasty, primary; lateral and alar cartilages and\/or elevation of nasal tip<\/td>\n<\/tr>\n | 30410 – Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and\/or elevation of nasal tip<\/td>\n<\/tr>\n | 30420 – Rhinoplasty, primary; including major septal repair<\/td>\n<\/tr>\n | 30430 – Rhinoplasty, secondary; minor revision (small amount of nasal tip work)<\/td>\n<\/tr>\n | 30435 – Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)<\/td>\n<\/tr>\n | 30450 – Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)<\/td>\n<\/tr>\n | 30460 – Rhinoplasty for nasal deformity secondary to congenital cleft lip and\/or palate, including columellar lengthening; tip only<\/td>\n<\/tr>\n | 30462 – Rhinoplasty for nasal deformity secondary to congenital cleft lip and\/or palate, including columellar lengthening; tip, septum, osteotomies<\/td>\n<\/tr>\n | 30465 – Repair of nasal vestibular stenosis (eg, spreader grafting, lateral nasal wall reconstruction)<\/td>\n<\/tr>\n | 30520 – Septoplasty or submucous resection, with or without cartilage scoring, contouring or replacement with graft<\/td>\n<\/tr>\n | 30540 – Repair choanal atresia; intranasal<\/td>\n<\/tr>\n | 30545 – Repair choanal atresia; transpalatine<\/td>\n<\/tr>\n | 30560 – Lysis intranasal synechia<\/td>\n<\/tr>\n | 30580 – Repair fistula; oromaxillary (combine with 31030 if antrotomy is included)<\/td>\n<\/tr>\n | 30600 – Repair fistula; oronasal<\/td>\n<\/tr>\n | 30620 – Septal or other intranasal dermatoplasty (does not include obtaining graft)<\/td>\n<\/tr>\n | 30630 – Repair nasal septal perforations<\/td>\n<\/tr>\n | 31000 – Lavage by cannulation; maxillary sinus (antrum puncture or natural ostium)<\/td>\n<\/tr>\n | 31020 – Sinusotomy, maxillary (antrotomy); intranasal<\/td>\n<\/tr>\n | 31030 – Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) without removal of antrochoanal polyps<\/td>\n<\/tr>\n | 31032 – Sinusotomy, maxillary (antrotomy); radical (Caldwell-Luc) with removal of antrochoanal polyps<\/td>\n<\/tr>\n | 31040 – Pterygomaxillary fossa surgery, any approach<\/td>\n<\/tr>\n | 31225 – Maxillectomy; without orbital exenteration<\/td>\n<\/tr>\n | 31230 – Maxillectomy; with orbital exenteration (en bloc)<\/td>\n<\/tr>\n | 31233 – Nasal\/sinus endoscopy, diagnostic with maxillary sinusoscopy (via inferior meatus or canine fossa puncture)<\/td>\n<\/tr>\n | 31235 – Nasal\/sinus endoscopy, diagnostic with sphenoid sinusoscopy (via puncture of sphenoidal face or cannulation of ostium)<\/td>\n<\/tr>\n | 31237 – Nasal\/sinus endoscopy, surgical; with biopsy, polypectomy or debridement ( separate procedure)<\/td>\n<\/tr>\n | 31238 – Nasal\/sinus endoscopy, surgical; with biopsy, polypectomy or debridement ( separate procedure); with control of nasal hemorrhage<\/td>\n<\/tr>\n | 31239 – Nasal\/sinus endoscopy, surgical; with biopsy, polypectomy or debridement ( separate procedure); with dacryocystorhinostomy<\/td>\n<\/tr>\n | 31240 – Nasal\/sinus endoscopy, surgical; with biopsy, polypectomy or debridement ( separate procedure); with concha bullosa resection<\/td>\n<\/tr>\n | 31254 – Nasal\/sinus endoscopy, surgical; with ethmoidectomy, partial (anterior)<\/td>\n<\/tr>\n | 31255 – Nasal\/sinus endoscopy, surgical; with ethmoidectomy, total (anterior and posterior)<\/td>\n<\/tr>\n | 31256 – Nasal\/sinus endoscopy, surgical, with maxillary antrostomy<\/td>\n<\/tr>\n | 31267 – Nasal\/sinus endoscopy, surgical, with maxillary antrostomy; with removal of tissue from maxillary sinus<\/td>\n<\/tr>\n | 31276 – Nasal\/sinus endoscopy, surgical with frontal sinus exploration, with or without removal of tissue from frontal sinus<\/td>\n<\/tr>\n | 31287 – Nasal\/sinus endoscopy, surgical, with sphenoidectomy<\/td>\n<\/tr>\n | 31288 – Nasal\/sinus endoscopy, surgical, with sphenoidotomy; with removal of tissue from the sphenoid sinus<\/td>\n<\/tr>\n | 31290 – Nasal\/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; ethmoid region<\/td>\n<\/tr>\n | 31291 – Nasal\/sinus endoscopy, surgical, with repair of cerebrospinal fluid leak; sphenoid region<\/td>\n<\/tr>\n | 31292 – Nasal\/sinus endoscopy, surgical; with medial or inferior orbital wall decompression<\/td>\n<\/tr>\n | 31293 – Nasal\/sinus endoscopy, surgical; with medial orbital wall and inferior orbital wall decompression<\/td>\n<\/tr>\n | 31294 – Nasal\/sinus endoscopy, surgical; with optic nerve decompression<\/td>\n<\/tr>\n | 31295 – Nasal\/sinus endoscopy, surgical; with dilation of maxillary sinus ostium (eg, balloon dilation), transnasal or via canine fossa<\/td>\n<\/tr>\n | 31296 – Nasal\/sinus endoscopy, surgical; with dilation of frontal sinus ostium (eg, balloon dilation)<\/td>\n<\/tr>\n | 31297 – Nasal\/sinus endoscopy, surgical; with dilation of sphenoid sinus ostium (eg, balloon dilation)<\/td>\n<\/tr>\n | 31360 – Laryngectomy; total, without radical neck dissection<\/td>\n<\/tr>\n | 31365 – Laryngectomy; total, with radical neck dissection<\/td>\n<\/tr>\n | 31367 – Laryngectomy; subtotal supraglottic, without radical neck dissection<\/td>\n<\/tr>\n | 31368 – Laryngectomy; subtotal supraglottic, with radical neck dissection<\/td>\n<\/tr>\n | 31370 – Partial laryngectomy (hemilaryngectomy); horizontal<\/td>\n<\/tr>\n | 31375 – Partial laryngectomy (hemilaryngectomy); laterovertical<\/td>\n<\/tr>\n | 31380 – Partial laryngectomy (hemilaryngectomy); anterovertical<\/td>\n<\/tr>\n | 31382 – Partial laryngectomy (hemilaryngectomy); antero-latero-vertical<\/td>\n<\/tr>\n | 31390 – Pharyngolaryngectomy, with radical neck dissection; without reconstruction<\/td>\n<\/tr>\n | 31395 – Pharyngolaryngectomy, with radical neck dissection; with reconstruction<\/td>\n<\/tr>\n | 31420 – Epiglottidectomy<\/td>\n<\/tr>\n | 31510 – Laryngoscopy, indirect; with biopsy<\/td>\n<\/tr>\n | 31512 – Laryngoscopy, indirect; with removal of lesion<\/td>\n<\/tr>\n | 31535 – Laryngoscopy, direct, operative, with biopsy;<\/td>\n<\/tr>\n | 31600 – Tracheostomy, planned (separate procedure);<\/td>\n<\/tr>\n | 31601 – Tracheostomy, planned (separate procedure); younger than 2 years<\/td>\n<\/tr>\n | 31603 – Tracheostomy, emergency procedure; transtracheal<\/td>\n<\/tr>\n | 31605 – Tracheostomy, emergency procedure; cricothyroid membrane<\/td>\n<\/tr>\n | 31610 – Tracheostomy, fenestration procedure with skin flaps<\/td>\n<\/tr>\n | 37609 – Ligation or biopsy, temporal artery<\/td>\n<\/tr>\n | 38500 – Biopsy or excision of lymph node(s); open, superficial<\/td>\n<\/tr>\n | 38510 – Biopsy or excision of lymph node(s); open, deep cervical node(s)<\/td>\n<\/tr>\n | 38542 – Dissection, deep jugular node(s)<\/td>\n<\/tr>\n | 38555 – Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection<\/td>\n<\/tr>\n | 38700 – Suprahyoid lymphadenectomy<\/td>\n<\/tr>\n | 38720 – Cervical lymphadenectomy (complete)<\/td>\n<\/tr>\n | 38724 – Cervical lymphadenectomy (modified radical neck dissection)<\/td>\n<\/tr>\n | 40490 – Biopsy of lip<\/td>\n<\/tr>\n | 40500 – Vermilionectomy (lip shave), with mucosal advancement<\/td>\n<\/tr>\n | 40510 – Excision of lip; transverse wedge excision with primary closure<\/td>\n<\/tr>\n | 40520 – Excision of lip; V-excision with primary direct linear closure<\/td>\n<\/tr>\n | 40525 – Excision of lip; full thickness, reconstruction with local flap (eg, Estlander or fan)<\/td>\n<\/tr>\n | 40527 – Excision of lip; full thickness, reconstruction with cross lip flap (Abbe-Estlander)<\/td>\n<\/tr>\n | 40530 – Resection of lip, more than one-fourth, without reconstruction<\/td>\n<\/tr>\n | 40650 – Repair lip, full thickness; vermilion only<\/td>\n<\/tr>\n | 40652 – Repair lip, full thickness; up to half vertical height<\/td>\n<\/tr>\n | 40654 – Repair lip, full thickness; over one-half vertical height, or complex<\/td>\n<\/tr>\n | 40700 – Plastic repair of cleft lip\/nasal deformity; primary, partial or complete, unilateral<\/td>\n<\/tr>\n | 40701 – Plastic repair of cleft lip\/nasal deformity; primary bilateral, 1-stage procedure<\/td>\n<\/tr>\n | 40702 – Plastic repair of cleft lip\/nasal deformity; primary bilateral, 1 of 2 stages<\/td>\n<\/tr>\n | 40720 – Plastic repair of cleft lip\/nasal deformity; secondary, by recreation of defect and reclosure<\/td>\n<\/tr>\n | 40761 – Plastic repair of cleft lip\/nasal deformity; with cross lip pedicle flap (Abbe-Estlander type), including sectioning and inserting of pedicle<\/td>\n<\/tr>\n | 40800 – Drainage of abscess, cyst, hematoma, vestibule of mouth; simple<\/td>\n<\/tr>\n | 40801 – Drainage of abscess, cyst, hematoma, vestibule of mouth; complicated<\/td>\n<\/tr>\n | 40804 – Removal of embedded foreign body, vestibule of mouth; simple<\/td>\n<\/tr>\n | 40805 – Removal of embedded foreign body, vestibule of mouth; complicated<\/td>\n<\/tr>\n | 40806 – Incision of labial frenum (frenotomy)<\/td>\n<\/tr>\n | 40808 – Biopsy, vestibule of mouth<\/td>\n<\/tr>\n | 40810 – Excision of lesion of mucosa and submucosa, vestibule of mouth; without repair<\/td>\n<\/tr>\n | 40812 – Excision of lesion of mucosa and submucosa, vestibule of mouth; with simple repair<\/td>\n<\/tr>\n | 40814 – Excision of lesion of mucosa and submucosa, vestibule of mouth; with complex repair<\/td>\n<\/tr>\n | 40816 – Excision of lesion of mucosa and submucosa, vestibule of mouth; complex, with excision of underlying muscle<\/td>\n<\/tr>\n | 40818 – Excision of mucosa of vestibule of mouth as donor graft<\/td>\n<\/tr>\n | 40819 – Excision of frenum, labial or buccal (frenumectomy, frenulectomy, frenectomy)<\/td>\n<\/tr>\n | 40820 – Destruction of lesion or scar of vestibule of mouth by physical methods (eg, laser, thermal, cryo, chemical)<\/td>\n<\/tr>\n | 40830 – Closure of laceration, vestibule of mouth; 2.5 cm or less<\/td>\n<\/tr>\n | 40831 – Closure of laceration, vestibule of mouth; over 2.5 cm or complex<\/td>\n<\/tr>\n | 40840 – Vestibuloplasty; anterior<\/td>\n<\/tr>\n | 40842 – Vestibuloplasty; posterior, unilateral<\/td>\n<\/tr>\n | 40843 – Vestibuloplasty; posterior, bilateral<\/td>\n<\/tr>\n | 40844 – Vestibuloplasty; entire arch<\/td>\n<\/tr>\n | 40845 – Vestibuloplasty; complex (including ridge extension, muscle repositioning)<\/td>\n<\/tr>\n | 41000 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; lingual<\/td>\n<\/tr>\n | 41005 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, superficial<\/td>\n<\/tr>\n | 41006 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; sublingual, deep, supramylohyoid<\/td>\n<\/tr>\n | 41007 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submental space<\/td>\n<\/tr>\n | 41008 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; submandibular space<\/td>\n<\/tr>\n | 41009 – Intraoral incision and drainage of abscess, cyst, or hematoma of tongue or floor of mouth; masticator space<\/td>\n<\/tr>\n | 41010 – Incision of lingual frenum (frenotomy)<\/td>\n<\/tr>\n | 41015 – Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; sublingual<\/td>\n<\/tr>\n | 41016 – Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submental<\/td>\n<\/tr>\n | 41017 – Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; submandibular<\/td>\n<\/tr>\n | 41018 – Extraoral incision and drainage of abscess, cyst, or hematoma of floor of mouth; masticator space<\/td>\n<\/tr>\n | 41100 – Biopsy of tongue; anterior two-thirds<\/td>\n<\/tr>\n | 41105 – Biopsy of tongue; posterior one-third<\/td>\n<\/tr>\n | 41108 – Biopsy of floor of mouth<\/td>\n<\/tr>\n | 41110 – Excision of lesion of tongue without closure<\/td>\n<\/tr>\n | 41112 – Excision of lesion of tongue with closure; anterior two-thirds<\/td>\n<\/tr>\n | 41113 – Excision of lesion of tongue with closure; posterior one-third<\/td>\n<\/tr>\n | 41114 – Excision of lesion of tongue with closure; with local tongue flap<\/td>\n<\/tr>\n | 41115 – Excision of lingual frenum (frenectomy)<\/td>\n<\/tr>\n | 41116 – Excision, lesion of floor of mouth<\/td>\n<\/tr>\n | 41120 – Glossectomy; less than one-half tongue<\/td>\n<\/tr>\n | 41130 – Glossectomy; hemiglossectomy<\/td>\n<\/tr>\n | 41135 – Glossectomy; partial, with unilateral radical neck dissection<\/td>\n<\/tr>\n | 41140 – Glossectomy; complete or total, with or without tracheostomy, without radical neck dissection<\/td>\n<\/tr>\n | 41145 – Glossectomy; complete or total, with or without tracheostomy, with unilateral radical neck dissection<\/td>\n<\/tr>\n | 41150 – Glossectomy; composite procedure with resection floor of mouth and mandibular resection, without radical neck dissection<\/td>\n<\/tr>\n | 41153 – Glossectomy; composite procedure with resection floor of mouth, with suprahyoid neck dissection<\/td>\n<\/tr>\n | 41155 – Glossectomy; composite procedure with resection floor of mouth, mandibular resection, and radical neck dissection (Commando type)<\/td>\n<\/tr>\n | 41250 – Repair of laceration 2.5 cm or less; floor of mouth and\/or anterior two-thirds of tongue<\/td>\n<\/tr>\n | 41251 – Repair of laceration 2.5 cm or less; posterior one-third of tongue<\/td>\n<\/tr>\n | 41252 – Repair of laceration of tongue, floor of mouth, over 2.6 cm or complex<\/td>\n<\/tr>\n | 41520 – Frenoplasty (surgical revision of frenum, eg, with z-plasty)<\/td>\n<\/tr>\n | 41599 – Unlisted procedure, tongue, floor of mouth<\/td>\n<\/tr>\n | 41800 – Drainage of abscess, cyst, hematoma from dentoalveolar structures<\/td>\n<\/tr>\n | 41805 – Removal of embedded foreign body from dentoalveolar structures; soft tissues<\/td>\n<\/tr>\n | 41806 – Removal of embedded foreign body from dentoalveolar structures; bone<\/td>\n<\/tr>\n | 41820 – Gingivectomy, excision gingiva, each quadrant<\/td>\n<\/tr>\n | 41821 – Operculectomy, excision pericoronal tissues<\/td>\n<\/tr>\n | 41822 – Excision of fibrous tuberosities, dentoalveolar structures<\/td>\n<\/tr>\n | 41823 – Excision of osseous tuberosities, dentoalveolar structures<\/td>\n<\/tr>\n | 41825 – Excision of lesion or tumor (except listed above), dentoalveolar structures; without repair<\/td>\n<\/tr>\n | 41826 – Excision of lesion or tumor (except listed above), dentoalveolar structures; with simple repair<\/td>\n<\/tr>\n | 41827 – Excision of lesion or tumor (except listed above), dentoalveolar structures; with complex repair<\/td>\n<\/tr>\n | 41828 – Excision of hyperplastic alveolar mucosa, each quadrant (specify)<\/td>\n<\/tr>\n | 41830 – Alveolectomy, including curettage of osteitis or sequestrectomy<\/td>\n<\/tr>\n | 41850 – Destruction of lesion (except excision), dentoalveolar structures<\/td>\n<\/tr>\n | 41872 – Gingivoplasty, each quadrant (specify)<\/td>\n<\/tr>\n | 41874 – Alveoloplasty, each quadrant (specify)<\/td>\n<\/tr>\n | 42000 – Drainage of abscess of palate, uvula<\/td>\n<\/tr>\n | 42100 – Biopsy of palate, uvula<\/td>\n<\/tr>\n | 42104 – Excision, lesion of palate, uvula; without closure<\/td>\n<\/tr>\n | 42106 – Excision, lesion of palate, uvula; with simple primary closure<\/td>\n<\/tr>\n | 42107 – Excision, lesion of palate, uvula; with local flap closure<\/td>\n<\/tr>\n | 42120 – Resection of palate or extensive resection of lesion<\/td>\n<\/tr>\n | 42140 – Uvulectomy, excision of uvula<\/td>\n<\/tr>\n | 42145 – Palatopharyngoplasty (eg, uvulopalatopharyngoplasty, uvulopharyngoplasty)<\/td>\n<\/tr>\n | 42160 – Destruction of lesion, palate or uvula ( thermal, cryo or chemical)<\/td>\n<\/tr>\n | 42180 – Repair, laceration of palate; up to 2 cm<\/td>\n<\/tr>\n | 42182 – Repair, laceration of palate; over 2 cm or complex<\/td>\n<\/tr>\n | 42200 – Palatoplasty for cleft palate, soft and\/or hard palate only<\/td>\n<\/tr>\n | 42205 – Palatoplasty for cleft palate, with closure of alveolar ridge; soft tissue only<\/td>\n<\/tr>\n | 42210 – Palatoplasty for cleft palate, with closure of alveolar ridge; with bone graft to alveolar ridge (includes obtaining graft)<\/td>\n<\/tr>\n | 42215 – Palatoplasty for cleft palate; major revision<\/td>\n<\/tr>\n | 42220 – Palatoplasty for cleft palate; secondary lengthening procedure<\/td>\n<\/tr>\n | 42225 – Palatoplasty for cleft palate; attachment pharyngeal flap<\/td>\n<\/tr>\n | 42226 – Lengthening of palate, and pharyngeal flap<\/td>\n<\/tr>\n | 42227 – Lengthening of palate, with island flap<\/td>\n<\/tr>\n | 42235 – Repair of anterior palate, including vomer flap<\/td>\n<\/tr>\n | 42260 – Repair of nasolabial fistula<\/td>\n<\/tr>\n | 42280 – Maxillary impression for palatal prosthesis<\/td>\n<\/tr>\n | 42281 – Insertion of pin-retained palatal prosthesis<\/td>\n<\/tr>\n | 42299 – Unlisted procedure, palate, uvula<\/td>\n<\/tr>\n | 42300 – Drainage of abscess; parotid, simple<\/td>\n<\/tr>\n | 42305 – Drainage of abscess; parotid, complicated<\/td>\n<\/tr>\n | 42310 – Drainage of abscess; submaxillary or sublingual, intraoral<\/td>\n<\/tr>\n | 42320 – Drainage of abscess; submaxillary, external<\/td>\n<\/tr>\n | 42325 – Fistulization sublingual salivary cyst (<\/td>\n<\/tr>\n | 42326 – Prosthesis, fistulization sublingual sal<\/td>\n<\/tr>\n | 42330 – Sialolithotomy; submandibular (submaxillary), sublingual or parotid, uncomplicated, intraoral<\/td>\n<\/tr>\n | 42335 – Sialolithotomy; submandibular (submaxillary), complicated, intraoral<\/td>\n<\/tr>\n | 42400 – Biopsy of salivary gland; needle<\/td>\n<\/tr>\n | 42405 – Biopsy of salivary gland; incisional<\/td>\n<\/tr>\n | 42408 – Excision of sublingual salivary cyst (ranula)<\/td>\n<\/tr>\n | 42409 – Marsupialization of sublingual salivary cyst (ranula)<\/td>\n<\/tr>\n | 42410 – Excision of parotid tumor or parotid gland; lateral lobe, without nerve dissection<\/td>\n<\/tr>\n | 42415 – Excision of parotid tumor or parotid gland; lateral lobe, with dissection and preservation of facial nerve<\/td>\n<\/tr>\n | 42420 – Excision of parotid tumor or parotid gland; total, with dissection and preservation of facial nerve<\/td>\n<\/tr>\n | 42425 – Excision of parotid tumor or parotid gland; total, en bloc removal with sacrifice of facial nerve<\/td>\n<\/tr>\n | 42426 – Excision of parotid tumor or parotid gland; total, with unilateral radical neck dissection<\/td>\n<\/tr>\n | 42440 – Excision of submandibular (submaxillary) gland<\/td>\n<\/tr>\n | 42450 – Excision of sublingual gland<\/td>\n<\/tr>\n | 42500 – Plastic repair of salivary duct, sialodochoplasty; primary or simple<\/td>\n<\/tr>\n | 42505 – Plastic repair of salivary duct, sialodochoplasty; secondary or complicated<\/td>\n<\/tr>\n | 42507 – Parotid duct diversion, bilateral (Wilke type procedure);<\/td>\n<\/tr>\n | 42509 – Parotid duct diversion, bilateral (Wilke type procedure); with excision of both submandibular glands<\/td>\n<\/tr>\n | 42510 – Parotid duct diversion, bilateral (Wilke type procedure); with ligation of both submandibular (Wharton’s) ducts<\/td>\n<\/tr>\n | 42550 – Injection procedure for sialography<\/td>\n<\/tr>\n | 42600 – Closure salivary fistula<\/td>\n<\/tr>\n | 42650 – Dilation salivary duct<\/td>\n<\/tr>\n | 42660 – Dilation and catheterization of salivary duct, with or without injection<\/td>\n<\/tr>\n | 42665 – Ligation salivary duct, intraoral<\/td>\n<\/tr>\n | 42699 – Unlisted procedure, salivary glands or ducts<\/td>\n<\/tr>\n | 42700 – Incision and drainage abscess; peritonsillar<\/td>\n<\/tr>\n | 42720 – Incision and drainage abscess; retropharyngeal or parapharyngeal, intraoral approach<\/td>\n<\/tr>\n | 42725 – Incision and drainage abscess; retropharyngeal or parapharyngeal, external approach<\/td>\n<\/tr>\n | 42800 – Biopsy; oropharynx<\/td>\n<\/tr>\n | 42804 – Biopsy; nasopharynx, visible lesion, simple<\/td>\n<\/tr>\n | 42806 – Biopsy; nasopharynx, survey for unknown primary lesion<\/td>\n<\/tr>\n | 42808 – Excision or destruction of lesion of pharynx, any method<\/td>\n<\/tr>\n | 42809 – Removal of foreign body from pharynx<\/td>\n<\/tr>\n | 42810 – Excision branchial cleft cyst or vestige, confined to skin and subcutaneous tissues<\/td>\n<\/tr>\n | 42815 – Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and\/or into pharynx<\/td>\n<\/tr>\n | 42842 – Radical resection of tonsil, tonsillar pillars, and\/or retromolar trigone; without closure<\/td>\n<\/tr>\n | 42844 – Radical resection of tonsil, tonsillar pillars, and\/or retromolar trigone; closure with local flap (eg, tongue, buccal)<\/td>\n<\/tr>\n | 42845 – Radical resection of tonsil, tonsillar pillars, and\/or retromolar trigone; closure with other flap<\/td>\n<\/tr>\n | 42860 – Excision of tonsil tags<\/td>\n<\/tr>\n | 42870 – Excision or destruction lingual tonsil, any method (separate procedure)<\/td>\n<\/tr>\n | 42890 – Limited pharyngectomy<\/td>\n<\/tr>\n | 42892 – Resection of lateral pharyngeal wall or pyriform sinus, direct closure by advancement of lateral and posterior pharyngeal walls<\/td>\n<\/tr>\n | 42894 – Resection of pharyngeal wall requiring closure with myocutaneous or fasciocutaneous flap or free muscle, skin, or fascial flap with microvascular anastomosis<\/td>\n<\/tr>\n | 42950 – Pharyngoplasty (plastic or reconstructive operation on pharynx)<\/td>\n<\/tr>\n | 60100 – Biopsy thyroid, percutaneous core needle<\/td>\n<\/tr>\n | 60200 – Excision of cyst or adenoma of thyroid, or transection of isthmus<\/td>\n<\/tr>\n | 60210 – Partial thyroid lobectomy, unilateral; with or without isthmusectomy<\/td>\n<\/tr>\n | 60212 – Partial thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy<\/td>\n<\/tr>\n | 60220 – Total thyroid lobectomy, unilateral; with or without isthmusectomy<\/td>\n<\/tr>\n | 60225 – Total thyroid lobectomy, unilateral; with contralateral subtotal lobectomy, including isthmusectomy<\/td>\n<\/tr>\n | 60240 – Thyroidectomy, total or complete<\/td>\n<\/tr>\n | 60252 – Thyroidectomy, total or subtotal for malignancy; with limited neck dissection<\/td>\n<\/tr>\n | 60254 – Thyroidectomy, total or subtotal for malignancy; with radical neck dissection<\/td>\n<\/tr>\n | 60260 – Thyroidectomy, removal of all remaining thyroid tissue following previous removal of a portion of thyroid<\/td>\n<\/tr>\n | 60270 – Thyroidectomy, including substernal thyroid; sternal split or transthoracic approach<\/td>\n<\/tr>\n | 60271 – Thyroidectomy, including substernal thyroid; cervical approach<\/td>\n<\/tr>\n | 60280 – Excision of thyroglossal duct cyst or sinus;<\/td>\n<\/tr>\n | 60281 – Excision of thyroglossal duct cyst or sinus; recurrent<\/td>\n<\/tr>\n | 61550 – Craniectomy for craniosynostosis; single cranial suture<\/td>\n<\/tr>\n | 61552 – Craniectomy for craniosynostosis; multiple cranial sutures<\/td>\n<\/tr>\n | 61556 – Craniotomy for craniosynostosis; frontal or parietal bone flap<\/td>\n<\/tr>\n | 61557 – Craniotomy for craniosynostosis; bifrontal bone flap<\/td>\n<\/tr>\n | 61558 – Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts<\/td>\n<\/tr>\n | 61559 – Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts)<\/td>\n<\/tr>\n | 61563 – Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression<\/td>\n<\/tr>\n | 61564 – Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression<\/td>\n<\/tr>\n | 62120 – Repair of encephalocele, skull vault, including cranioplasty<\/td>\n<\/tr>\n | 62121 – Craniotomy for repair of encephalocele, skull base<\/td>\n<\/tr>\n | 62140 – Cranioplasty for skull defect; up to 5 cm diameter<\/td>\n<\/tr>\n | 62141 – Cranioplasty for skull defect; larger than 5 cm diameter<\/td>\n<\/tr>\n | 62142 – Removal of bone flap or prosthetic plate of skull<\/td>\n<\/tr>\n | 62143 – Replacement of bone flap or prosthetic plate of skull<\/td>\n<\/tr>\n | 62145 – Cranioplasty for skull defect with reparative brain surgery<\/td>\n<\/tr>\n | 62146 – Cranioplasty with autograft (includes obtaining bone grafts); up to 5 cm diameter<\/td>\n<\/tr>\n | 62147 – Cranioplasty with autograft (includes obtaining bone grafts); larger than 5 cm diameter<\/td>\n<\/tr>\n | 62148 – Incision and retrieval of subcutaneous cranial bone graft for cranioplasty (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 64600 – Destruction by neurolytic agent, trigeminal nerve; supraorbital, infraorbital, mental, or inferior alveolar branch<\/td>\n<\/tr>\n | 64605 – Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale<\/td>\n<\/tr>\n | 64610 – Destruction by neurolytic agent, trigeminal nerve; second and third division branches at foramen ovale under radiologic monitoring<\/td>\n<\/tr>\n | 64612 – Chemodenervation of muscle(s); muscle(s) innervated by facial nerve, unilateral (eg. For blepharospasm, hemifacial spasm)<\/td>\n<\/tr>\n | 64615 – Chemodenervation of muscle(s); muscle(s) innervated by facial, trigeminal, cervical spinal and accessory nerves, bilateral (eg. for chronic migraine)<\/td>\n<\/tr>\n | 64616 – Chemodenervation of muscle(s); neck muscle(s), excluding muscles of the larynx, unilateral (eg. for cervical dystonia, spasmodic torticollis)<\/td>\n<\/tr>\n | 64716 – Neuroplasty and\/or transposition; cranial nerve (specify)<\/td>\n<\/tr>\n | 64722 – Decompression; unspecified nerve(s) (specify)<\/td>\n<\/tr>\n | 64727 – Internal neurolysis, requiring use of operating microscope (List separately in addition to code for neuroplasty) (Neuroplasty includes external neurolysis)<\/td>\n<\/tr>\n | 64732 – Transection or avulsion of; supraorbital nerve<\/td>\n<\/tr>\n | 64734 – Transection or avulsion of; infraorbital nerve<\/td>\n<\/tr>\n | 64736 – Transection or avulsion of; mental nerve<\/td>\n<\/tr>\n | 64738 – Transection or avulsion of; inferior alveolar nerve by osteotomy<\/td>\n<\/tr>\n | 64740 – Transection or avulsion of; lingual nerve<\/td>\n<\/tr>\n | 64742 – Transection or avulsion of; facial nerve, differential or complete<\/td>\n<\/tr>\n | 64744 – Transection or avulsion of; greater occipital nerve<\/td>\n<\/tr>\n | 64864 – Suture of facial nerve; extracranial<\/td>\n<\/tr>\n | 64885 – Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length<\/td>\n<\/tr>\n | 64886 – Nerve graft (includes obtaining graft), head or neck; more than 4 cm length<\/td>\n<\/tr>\n | 64902 – Nerve graft, each additional nerve; multiple strands (cable) (List separately in addition to code for primary procedure)<\/td>\n<\/tr>\n | 64910 – Nerve repair; with synthetic conduit or vein allograft (eg, nerve tube), each nerve<\/td>\n<\/tr>\n | 64911 – Nerve repair; with autogenous vein graft (includes harvest of vein graft), each nerve<\/td>\n<\/tr>\n | 67900 – Repair of brow ptosis (supraciliary, mid-forehead or coronal approach)<\/td>\n<\/tr>\n | 67901 – Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)<\/td>\n<\/tr>\n | 67902 – Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)<\/td>\n<\/tr>\n | 67903 – Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach<\/td>\n<\/tr>\n | 67904 – Repair of blepharoptosis; (tarso) levator resection or advancement, external approach<\/td>\n<\/tr>\n | 67906 – Repair of blepharoptosis; superior rectus technique with fascial sling (includes obtaining fascia)<\/td>\n<\/tr>\n | 67908 – Repair of blepharoptosis; conjunctivo-tarso-Muller’s muscle-levator resection (eg, Fasanella-Servat type)<\/td>\n<\/tr>\n | 67909 – Reduction of overcorrection of ptosis<\/td>\n<\/tr>\n | 67911 – Correction of lid retraction<\/td>\n<\/tr>\n | 67912 – Correction of lagophthalmos, with implantation of upper eyelid lid load (eg, gold weight)<\/td>\n<\/tr>\n | 67914 – Repair of ectropion; suture<\/td>\n<\/tr>\n | 67915 – Repair of ectropion; thermocauterization<\/td>\n<\/tr>\n | 67916 – Repair of ectropion; excision tarsal wedge<\/td>\n<\/tr>\n | 67917 – Repair of ectropion; extensive (eg, tarsal strip operations)<\/td>\n<\/tr>\n | 67921 – Repair of entropion; suture<\/td>\n<\/tr>\n | 67922 – Repair of entropion; thermocauterization<\/td>\n<\/tr>\n | 67923 – Repair of entropion; excision tarsal wedge<\/td>\n<\/tr>\n | 67924 – Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)<\/td>\n<\/tr>\n | 67930 – Suture of recent wound, eyelid, involving lid margin, tarsus, and\/or palpebral conjunctiva direct closure; partial thickness<\/td>\n<\/tr>\n | 67935 – Suture of recent wound, eyelid, involving lid margin, tarsus, and\/or palpebral conjunctiva direct closure; full thickness<\/td>\n<\/tr>\n | 67950 – Canthoplasty (reconstruction of canthus)<\/td>\n<\/tr>\n | 67961 – Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; up to one-fourth of lid margin<\/td>\n<\/tr>\n | 67966 – Excision and repair of eyelid, involving lid margin, tarsus, conjunctiva, canthus, or full thickness, may include preparation for skin graft or pedicle flap with adjacent tissue transfer or rearrangement; over one-fourth of lid margin<\/td>\n<\/tr>\n | 67971 – Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; up to two-thirds of eyelid, 1 stage or first stage<\/td>\n<\/tr>\n | 67973 – Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage<\/td>\n<\/tr>\n | 67974 – Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, upper, 1 stage or first stage<\/td>\n<\/tr>\n | 67975 – Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; second stage<\/td>\n<\/tr>\n | 67999 – Unlisted procedure, eyelids<\/td>\n<\/tr>\n | 69100 – Biopsy external ear<\/td>\n<\/tr>\n | 69105 – Biopsy external auditory canal<\/td>\n<\/tr>\n | 69110 – Excision external ear; partial, simple repair<\/td>\n<\/tr>\n | 69120 – Excision external ear; complete amputation<\/td>\n<\/tr>\n | 69145 – Excision soft tissue lesion, external auditory canal<\/td>\n<\/tr>\n | 69300 – Otoplasty, protruding ear, with or without size reduction<\/td>\n<\/tr>\n | 69310 – Reconstruction of external auditory canal (meatoplasty) (eg, for stenosis due to injury, infection) (separate procedure)<\/td>\n<\/tr>\n | 69320 – Reconstruction external auditory canal for congenital atresia, single stage<\/td>\n<\/tr>\n | 69399 – Unlisted procedure, external ear<\/td>\n<\/tr>\n | 99252 – Inpatient consultation for a new or established patient<\/td>\n<\/tr>\n | D4210 – Gingivectomy or gingivoplasty – four or more contiguous teeth or tooth bounded spaces per quadrant<\/td>\n<\/tr>\n | D4211 – Gingivectomy or gingivoplasty – one to three contiguous teeth or tooth bounded spaces per quadrant<\/td>\n<\/tr>\n | D4212 – Gingivectomy or gingivoplasty to allow access for restorative procedure, per tooth<\/td>\n<\/tr>\n | D4230 – Anatomical crown exposure – four or more contiguous teeth per quadrant<\/td>\n<\/tr>\n | D4231 – Anatomical crown exposure – one to three teeth per quadrant<\/td>\n<\/tr>\n | D4245 – Apically positioned flap<\/td>\n<\/tr>\n | D4249 – Clinical crown lengthening \u00e2\u20ac\u201c hard tissue<\/td>\n<\/tr>\n | D4250 – Clinical crown lengthening \u00e2\u20ac\u201c hard tissue<\/td>\n<\/tr>\n | D4260 – Osseous surgery (including elevation of a full thickness flap and closure) \u00e2\u20ac\u201c four or more contiguous teeth or tooth bounded spaces per quadrant<\/td>\n<\/tr>\n | D4261 – Osseous surgery (including elevation of a full thickness flap and closure) \u00e2\u20ac\u201c one to three contiguous teeth or tooth bounded spaces per quadrant<\/td>\n<\/tr>\n | D4262 – Osseous surgery (including elevation of a full thickness flap and closure) \u00e2\u20ac\u201c one to three contiguous teeth or tooth bounded spaces per quadrant<\/td>\n<\/tr>\n | D4263 – Bone replacement graft – first site in quadrant<\/td>\n<\/tr>\n | D4264 – Bone replacement graft – each additional site in quadrant<\/td>\n<\/tr>\n | D4265 – Bone replacement graft – each additional site in quadrant<\/td>\n<\/tr>\n | D4266 – Guided tissue regeneration – resorbable barrier, per site<\/td>\n<\/tr>\n | D4267 – Guided tissue regeneration – nonresorbable barrier, per site (includes membrane removal)<\/td>\n<\/tr>\n | D4268 – Surgical revision procedure, per tooth<\/td>\n<\/tr>\n | D4270 – Pedicle soft tissue graft procedure<\/td>\n<\/tr>\n | D4273 – Autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft<\/td>\n<\/tr>\n | D4274 – Distal or proximal wedge procedure (when not performed in conjunction with surgical procedures in the same anatomical area)<\/td>\n<\/tr>\n | D4275 – Non-autogenous connective tissue graft (including recipient site and donor material) first tooth, implant, or edentulous tooth position in graft<\/td>\n<\/tr>\n | D4276 – Combined connective tissue and double pedicle graft, per tooth<\/td>\n<\/tr>\n | D4277 – Free soft tissue graft procedure (including recipient and donor surgical sites) first tooth, implant or edentulous tooth position in graft<\/td>\n<\/tr>\n | D4278 – Free soft tissue graft procedure (including recipient and donor surgical sites) each additional contiguous tooth, implant or edentulous tooth position in same graft site<\/td>\n<\/tr>\n | D6010 – Surgical placement of implant body: endosteal implant<\/td>\n<\/tr>\n | D7111 – Extraction, coronal remnants – deciduous tooth<\/td>\n<\/tr>\n | D7120 – Extraction, coronal remnants – deciduous tooth<\/td>\n<\/tr>\n | D7130 – Extraction, coronal remnants – deciduous tooth<\/td>\n<\/tr>\n | D7140 – Extraction, erupted tooth or exposed root (elevation and\/or forceps removal)<\/td>\n<\/tr>\n | D7210 – Surgical removal of erupted tooth requiring removal of bone and\/or sectioning of tooth, and including elevation of mucoperiosteal flap if indicated<\/td>\n<\/tr>\n | D7220 – Removal of impacted tooth – soft tissue<\/td>\n<\/tr>\n | D7230 – Removal of impacted tooth – partially bony<\/td>\n<\/tr>\n | D7240 – Removal of impacted tooth – completely bony<\/td>\n<\/tr>\n | D7241 – Removal of impacted tooth – completely bony, with unusual surgical complications<\/td>\n<\/tr>\n | D7250 – Surgical removal of residual tooth roots (cutting procedure)<\/td>\n<\/tr>\n | D7251 – Coronectomy \u00e2\u20ac\u201c intentional partial tooth removal<\/td>\n<\/tr>\n | D7270 – Tooth reimplantation and\/or stabilization of accidentally evulsed or displaced tooth<\/td>\n<\/tr>\n | D7272 – Tooth transplantation (includes reimplantation from one site to another and splinting and\/or stabilization)<\/td>\n<\/tr>\n | D7280 – Surgical access of an unerupted tooth<\/td>\n<\/tr>\n | D7282 – Mobilization of erupted or malpositioned tooth to aid eruption<\/td>\n<\/tr>\n | D7283 – Placement of device to facilitate eruption of impacted tooth<\/td>\n<\/tr>\n | D7290 – Surgical repositioning of teeth<\/td>\n<\/tr>\n | D7291 – Transseptal fiberotomy\/supra crestal fiberotomy, by report<\/td>\n<\/tr>\n | D7292 – Surgical placement of temporary anchorage device [screw retained plate] requiring flap; includes device removal<\/td>\n<\/tr>\n | D7293 – Surgical placement of temporary anchorage device requiring flap; includes device removal<\/td>\n<\/tr>\n | D7294 – Surgical placement of temporary anchorage device without flap; includes device removal<\/td>\n<\/tr>\n | D7310 – Alveoloplasty in conjunction with extractions – four or more teeth or tooth spaces, per quadrant<\/td>\n<\/tr>\n | D7311 – Alveoloplasty in conjunction with extractions – one to three teeth or tooth spaces, per quadrant<\/td>\n<\/tr>\n | D7320 – Alveoloplasty not in conjunction with extractions – four or more teeth or tooth spaces, per quadrant<\/td>\n<\/tr>\n | D7321 – Alveoloplasty not in conjunction with extractions – one to three teeth or tooth spaces, per quadrant<\/td>\n<\/tr>\n | D7471 – Removal of lateral exostosis (maxilla or mandible)<\/td>\n<\/tr>\n | D7485 – Surgical reduction of osseous tuberosity<\/td>\n<\/tr>\n | D7951 – Sinus augmentation with bone or bone substitutes via a lateral open approach<\/td>\n<\/tr>\n | D7952 – Sinus augmentation via a vertical approach<\/td>\n<\/tr>\n | D7953 – Bone replacement graft for ridge preservation – per site<\/td>\n<\/tr>\n | General\/Deep Sedation (required for accreditation)<\/td>\n<\/tr>\n | Moderate (Conscious) Sedation (not required for accreditation<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n | |
|---|