11470 - 11623 surgery/integumentary system...surgery/integumentary sy s tem 11470 - 11623 11470 -...

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23Surgery/Integumentary System11470 - 11623

CPT® is a registered trademark of the American Medical Association. All rights reserved.500

New Code Revised Code Add-On Code # Resequenced Code FDA Approval Pending Modifier 51 Exempt Modifier 63 Exempt Female-only Procedure Male-only Procedure Maternity MIPS Code Telemedicine Code FRVU Facility Total RVU

NFRVU Non-facility Total RVU GD Global Days MUE Medically Unlikely Edit MOD Modifier Crosswalk Conscious Sedation Included

ASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: APR 2018; Vol 28: Issue 2, OCT 2016; Vol 26: Issue 8, AUG 2000; Vol 10: Issue 8

11470 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with simple or intermediate repair FRVU 8.05 NFRVU 11.70 GD 090 MUE 3 MOD 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: APR 2018; Vol 28: Issue 2, OCT 2016; Vol 26: Issue 8, AUG 2000; Vol 10: Issue 8

11471 Excision of skin and subcutaneous tissue for hidradenitis, perianal, perineal, or umbilical; with complex repair FRVU 10.04 NFRVU 14.51 GD 090 MUE 2 MOD 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: APR 2018; Vol 28: Issue 2, OCT 2016; Vol 26: Issue 8, MAY 2012; Vol 22: Issue 5, APR 2010; Vol 20: Issue 4, AUG 2000; Vol 10: Issue 8

Excision-Malignant Lesions Procedures on the Skin (11600-11646)11600 Excision, malignant lesion including margins, trunk, arms,

or legs; excised diameter 0.5 cm or less FRVU 3.43 NFRVU 5.46 GD 010 MUE 2 MOD 22, 51, 53, 54, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, MAY 2012; Vol 22: Issue 5, JUL 2012; Vol 22: Issue 7, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, NOV 2002; Vol 12: Issue 11, AUG 2000; Vol 10: Issue 8

11601 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 0.6 to 1.0 cm FRVU 4.29 NFRVU 6.50 GD 010 MUE 2 MOD 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11602 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 1.1 to 2.0 cm FRVU 4.71 NFRVU 7.05 GD 010 MUE 3 MOD 51, 54, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11603 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 2.1 to 3.0 cm FRVU 5.65 NFRVU 8.06 GD 010 MUE 2

MOD 51, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10

11604 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter 3.1 to 4.0 cm FRVU 6.22 NFRVU 8.96 GD 010 MUE 2 MOD 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11606 Excision, malignant lesion including margins, trunk, arms, or legs; excised diameter over 4.0 cm FRVU 9.24 NFRVU 12.82 GD 010 MUE 2 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, JUL 2012; Vol 22: Issue 7, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11620 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.5 cm or less FRVU 3.47 NFRVU 5.51 GD 010 MUE 2 MOD 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, JUL 2012; Vol 22: Issue 7, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, NOV 2002; Vol 12: Issue 11, AUG 2000; Vol 10: Issue 8

11621 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 0.6 to 1.0 cm FRVU 4.32 NFRVU 6.54 GD 010 MUE 2 MOD 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11622 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 1.1 to 2.0 cm FRVU 4.95 NFRVU 7.29 GD 010 MUE 2 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11623 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 2.1 to 3.0 cm

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Surgery/Integumentary System 11624 - 11719

501CPT® is a registered trademark of the American Medical Association. All rights reserved.

ASC PI ASC Payment Indicator ASC Sep. Pay ASC Separate Payment APC SI APC Status Indicator APC APC Value G Code Crosswalk CPT Asst CPT® Assistant Article Reference NATIONAL LIMIT Maximum Reimbursement Amount MID POINT Median Fee Schedule Amount FLOOR Percentage of Fee Schedule HCPCS CODE DOSAGE A Dosage Amount for Drug PAYMENT LIMIT Maximum Reimbursement Amount

FRVU 6.12 NFRVU 8.55 GD 010 MUE 2 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11624 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter 3.1 to 4.0 cm FRVU 6.94 NFRVU 9.65 GD 010 MUE 2 MOD 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11626 Excision, malignant lesion including margins, scalp, neck, hands, feet, genitalia; excised diameter over 4.0 cm FRVU 8.50 NFRVU 11.61 GD 010 MUE 2 MOD 51, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11640 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.5 cm or less FRVU 3.59 NFRVU 5.69 GD 010 MUE 2 MOD 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, NOV 2002; Vol 12: Issue 11, AUG 2000; Vol 10: Issue 8

11641 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 0.6 to 1.0 cm FRVU 4.50 NFRVU 6.76 GD 010 MUE 2 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11642 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 1.1 to 2.0 cm FRVU 5.31 NFRVU 7.72 GD 010 MUE 3 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11643 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 2.1 to 3.0 cm

FRVU 6.65 NFRVU 9.10 GD 010 MUE 2 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11644 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter 3.1 to 4.0 cm FRVU 8.22 NFRVU 11.21 GD 010 MUE 2 MOD 51, 52, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5072CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, FEB 2010; Vol 20: Issue 2, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

11646 Excision, malignant lesion including margins, face, ears, eyelids, nose, lips; excised diameter over 4.0 cm FRVU 11.42 NFRVU 14.66 GD 010 MUE 2 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: MAR 2014; Vol 24: Issue 3, MAR 2014; Vol 24: Issue 3, MAY 2012; Vol 22: Issue 5, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, FEB 2008; Vol 18: Issue 2, OCT 2004; Vol 14: Issue 10, AUG 2000; Vol 10: Issue 8

Surgical Procedures on the Nails (11719-11765)11719 Trimming of nondystrophic nails, any number

G Code Crosswalk G0247FRVU 0.22 NFRVU 0.40 GD 000 MUE 1

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MOD 22, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, Q7, Q8, Q9, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5733CPT® Asst: DEC 2002; Vol 12: Issue 12

11720 Debridement of nail(s) by any method(s); 1 to 5 G Code Crosswalk G0247FRVU 0.42 NFRVU 0.91 GD 000 MUE 1 MOD 51, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, Q7, Q8, Q9, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5733CPT® Asst: DEC 2002; Vol 12: Issue 12

11721 Debridement of nail(s) by any method(s); 6 or more G Code Crosswalk G0247FRVU 0.71 NFRVU 1.27 GD 000 MUE 1 MOD 51, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, Q7, Q8, Q9, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5733CPT® Asst: DEC 2002; Vol 12: Issue 12

11730 Avulsion of nail plate, partial or complete, simple; single FRVU 1.59 NFRVU 2.97 GD 000 MUE 1 MOD 51, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: DEC 2003; Vol 13: Issue 12, DEC 2002; Vol 12: Issue 12

11732 Avulsion of nail plate, partial or complete, simple; each additional nail plate (List separately in addition to code for primary procedure) FRVU 0.51 NFRVU 0.90 GD ZZZ MUE 9 MOD 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: DEC 2002; Vol 12: Issue 12

11740 Evacuation of subungual hematoma FRVU 0.93 NFRVU 1.40 GD 000 MUE 3 MOD 22, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5734CPT® Asst: DEC 2002; Vol 12: Issue 12

11750 Excision of nail and nail matrix, partial or complete (eg, ingrown or deformed nail), for permanent removal FRVU 3.24 NFRVU 4.34 GD 010 MUE 6 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: DEC 2002; Vol 12: Issue 12

11755 Biopsy of nail unit (eg, plate, bed, matrix, hyponychium, proximal and lateral nail folds) (separate procedure) FRVU 2.22 NFRVU 3.77 GD 000 MUE 4

MOD 22, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5071CPT® Asst: OCT 2004; Vol 14: Issue 10, DEC 2002; Vol 12: Issue 12

11760 Repair of nail bed FRVU 3.28 NFRVU 5.35 GD 010 MUE 4 MOD 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: G2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: DEC 2002; Vol 12: Issue 12

11762 Reconstruction of nail bed with graft FRVU 5.23 NFRVU 7.90 GD 010 MUE 2 MOD 22, 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: DEC 2002; Vol 12: Issue 12

11765 Wedge excision of skin of nail fold (eg, for ingrown toenail) FRVU 2.69 NFRVU 4.74 GD 010 MUE 4 MOD 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: DEC 2002; Vol 12: Issue 12

Surgical Procedures on the Pilonidal Cyst (11770-11772)11770 Excision of pilonidal cyst or sinus; simple

FRVU 5.31 NFRVU 7.87 GD 010 MUE 1 MOD 22, 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073

11771 Excision of pilonidal cyst or sinus; extensive FRVU 12.46 NFRVU 16.30 GD 090 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073

11772 Excision of pilonidal cyst or sinus; complicated FRVU 16.51 NFRVU 19.75 GD 090 MUE 1 MOD 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5073CPT® Asst: DEC 2015; Vol 25: Issue 9

Introduction or Removal Procedures on the Integumentary System (11900-11983)11900 Injection, intralesional; up to and including 7 lesions

FRVU 0.90 NFRVU 1.58 GD 000 MUE 1 MOD 22, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: NOV 2013; Vol 23: Issue 11, SEP 2004; Vol 14: Issue 9, FEB 2000; Vol 10: Issue 2, FEB 2000; Vol 10: Issue 2

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11901 Injection, intralesional; more than 7 lesions FRVU 1.40 NFRVU 1.99 GD 000 MUE 1 MOD 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: SEP 2004; Vol 14: Issue 9, FEB 2000; Vol 10: Issue 2, FEB 2000; Vol 10: Issue 2

11920 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.0 sq cm or less FRVU 3.27 NFRVU 4.83 GD 000 MUE 1 MOD 22, 47, 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: OCT 2016; Vol 26: Issue 8

11921 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; 6.1 to 20.0 sq cm FRVU 3.85 NFRVU 5.61 GD 000 MUE 1 MOD 22, 47, 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: OCT 2016; Vol 26: Issue 8

11922 Tattooing, intradermal introduction of insoluble opaque pigments to correct color defects of skin, including micropigmentation; each additional 20.0 sq cm, or part thereof (List separately in addition to code for primary procedure) FRVU 0.86 NFRVU 1.74 GD ZZZ MUE 1 MOD 22, 47, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No

11950 Subcutaneous injection of filling material (eg, collagen); 1 cc or less G Code Crosswalk G0429FRVU 1.53 NFRVU 2.21 GD 000 MUE 1 MOD 22, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5051CPT® Asst: JUN 2012; Vol 22: Issue 6

11951 Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc G Code Crosswalk G0429FRVU 2.09 NFRVU 2.84 GD 000 MUE 1 MOD 22, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5053

11952 Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc G Code Crosswalk G0429FRVU 2.69 NFRVU 3.54 GD 000 MUE 1 MOD 22, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5053

11954 Subcutaneous injection of filling material (eg, collagen); over 10.0 cc G Code Crosswalk G0429

FRVU 3.31 NFRVU 4.49 GD 000 MUE 1 MOD 22, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: JUN 2012; Vol 22: Issue 6

11960 Insertion of tissue expander(s) for other than breast, including subsequent expansion FRVU 27.26 NFRVU 27.26 GD 090 MUE 2 MOD 22, 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5055

11970 Replacement of tissue expander with permanent prosthesis FRVU 17.50 NFRVU 17.50 GD 090 MUE 2 MOD 50, 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: J1 APC: 5114CPT® Asst: JAN 2013; Vol 23: Issue 1, AUG 2005; Vol 15: Issue 8

11971 Removal of tissue expander(s) without insertion of prosthesis FRVU 9.11 NFRVU 13.33 GD 090 MUE 2 MOD 47, 50, 51, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: J1 APC: 5073CPT® Asst: JUN 2005; Vol 15: Issue 6

11976 Removal, implantable contraceptive capsules FRVU 2.70 NFRVU 4.05 GD 000 MUE 1 MOD 22, 33, 47, 51, 52, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: No APC SI: T APC: 5071

11980 Subcutaneous hormone pellet implantation (implantation of estradiol and/or testosterone pellets beneath the skin) FRVU 1.62 NFRVU 2.67 GD 000 MUE 1 MOD 22, 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, FP, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5735

11981 Insertion, non-biodegradable drug delivery implant FRVU 2.39 NFRVU 4.01 GD XXX MUE 1 MOD 33, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, FP, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5734CPT® Asst: APR 2011; Vol 21: Issue 4

11982 Removal, non-biodegradable drug delivery implant FRVU 2.90 NFRVU 4.55 GD XXX MUE 1 MOD 33, 47, 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, FP, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5735

11983 Removal with reinsertion, non-biodegradable drug delivery implant FRVU 5.06 NFRVU 6.42 GD XXX MUE 1 MOD 33, 47, 51, 58, 59, 76, 77, 78, 79, 99, AQ, AR, FP, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: S APC: 5735

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Surgical Repair (Closure) Procedures on the Integumentary System (12001-16036)

Repair-Simple Procedures on the Integumentary System (12001-12021)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 FRVU 1.27 NFRVU 2.54 GD 000 MUE 1 MOD 51, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: FEB 2018; Vol 27: Issue 12, FEB 2008; Vol 18: Issue 2, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JAN 2000; Vol 10: Issue 1, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7

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 FRVU 1.68 NFRVU 3.08 GD 000 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: OCT 2014; Vol 24: Issue 10, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

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 FRVU 2.10 NFRVU 3.62 GD 000 MUE 1 MOD 51, 53, 54, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

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 FRVU 2.73 NFRVU 4.57 GD 000 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

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 FRVU 3.36 NFRVU 5.40 GD 000 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12007 Simple repair of superficial wounds of scalp, neck, axillae, external genitalia, trunk and/or extremities (including hands and feet); over 30.0 cm FRVU 4.21 NFRVU 6.21 GD 000 MUE 1 MOD 51, 52, 53, 54, 55, 56, 58, 59, 62, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5051CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12011 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less FRVU 1.58 NFRVU 3.10 GD 000 MUE 1 MOD 22, 51, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: JAN 2017; Vol 26: Issue 11, MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, APR 2000; Vol 10: Issue 4, MAY 2000; Vol 10: Issue 5, JUL 2000; Vol 10: Issue 7

12013 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm FRVU 1.66 NFRVU 3.23 GD 000 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, MAY 2000; Vol 10: Issue 5, JUL 2000; Vol 10: Issue 7

12014 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm FRVU 2.14 NFRVU 3.78 GD 000 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12015 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm FRVU 2.70 NFRVU 4.58 GD 000 MUE 1 MOD 22, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: G2 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12016 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm FRVU 3.68 NFRVU 5.79 GD 000 MUE 1 MOD 22, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XU

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ASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12017 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm FRVU 4.48 NFRVU 4.48 GD 000 MUE 1 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12018 Simple repair of superficial wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm FRVU 5.07 NFRVU 5.07 GD 000 MUE 1 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 80, 81, 82, 99, AQ, AR, AS, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5051CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2008; Vol 18: Issue 2, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12020 Treatment of superficial wound dehiscence; simple closure FRVU 5.41 NFRVU 7.96 GD 010 MUE 2 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

12021 Treatment of superficial wound dehiscence; with packing FRVU 3.94 NFRVU 4.61 GD 010 MUE 3 MOD 51, 53, 54, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: FEB 2008; Vol 18: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7

Repair-Intermediate Procedures on the Integumentary System (12031-12057)12031 Repair, intermediate, wounds of scalp, axillae, trunk and/or

extremities (excluding hands and feet); 2.5 cm or less FRVU 4.41 NFRVU 6.74 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: APR 2010; Vol 20: Issue 4, FEB 2007; Vol 17: Issue 2, AUG 2006; Vol 16: Issue 8, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12032 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 2.6 cm to 7.5 cm FRVU 5.62 NFRVU 8.61 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XU

ASC PI: P2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12034 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 7.6 cm to 12.5 cm FRVU 5.98 NFRVU 8.86 GD 010 MUE 1 MOD 51, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12035 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 12.6 cm to 20.0 cm FRVU 6.91 NFRVU 10.81 GD 010 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12036 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); 20.1 cm to 30.0 cm FRVU 8.03 NFRVU 11.96 GD 010 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12037 Repair, intermediate, wounds of scalp, axillae, trunk and/or extremities (excluding hands and feet); over 30.0 cm FRVU 9.47 NFRVU 13.68 GD 010 MUE 1 MOD 51, 52, 53, 54, 55, 56, 58, 59, 62, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12041 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.5 cm or less FRVU 4.34 NFRVU 6.73 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P3 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12042 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 2.6 cm to 7.5 cm FRVU 5.79 NFRVU 8.21 GD 010 MUE 1

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MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: P2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12044 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 7.6 cm to 12.5 cm FRVU 6.19 NFRVU 10.19 GD 010 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12045 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 12.6 cm to 20.0 cm FRVU 7.76 NFRVU 11.37 GD 010 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12046 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; 20.1 cm to 30.0 cm FRVU 8.90 NFRVU 13.50 GD 010 MUE 1 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12047 Repair, intermediate, wounds of neck, hands, feet and/or external genitalia; over 30.0 cm FRVU 10.64 NFRVU 15.57 GD 010 MUE 1 MOD 47, 51, 52, 53, 54, 55, 56, 58, 59, 62, 76, 77, 78, 79, 80, 81, 82, 99, AQ, AR, AS, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2013; Vol 23: Issue 1, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12051 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.5 cm or less FRVU 4.94 NFRVU 7.32 GD 010 MUE 1 MOD 22, 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12052 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 2.6 cm to 5.0 cm FRVU 5.89 NFRVU 8.35 GD 010 MUE 1 MOD 51, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, JUL 2008; Vol 18: Issue 7, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12053 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 5.1 cm to 7.5 cm FRVU 6.28 NFRVU 9.80 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: P2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12054 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 7.6 cm to 12.5 cm FRVU 6.41 NFRVU 10.22 GD 010 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12055 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm FRVU 8.79 NFRVU 13.24 GD 010 MUE 1 MOD 22, 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12056 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 20.1 cm to 30.0 cm FRVU 9.85 NFRVU 13.92 GD 010 MUE 1 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: No APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

12057 Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; over 30.0 cm FRVU 11.28 NFRVU 15.43 GD 010 MUE 1 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 62, 76, 77, 78, 79, 80, 81, 82, 99, AQ, AR, AS, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: MAY 2014; Vol 24: Issue 5, APR 2010; Vol 20: Issue 4, FEB 2007; Vol 17: Issue 2, JAN 2002; Vol 12: Issue 1, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

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Repair-Complex Procedures on the Integumentary System (13100-13160)13100 Repair, complex, trunk; 1.1 cm to 2.5 cm

FRVU 5.95 NFRVU 9.50 GD 010 MUE 1 MOD 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: JUN 2017; Vol 27: Issue 4, JAN 2012; Vol 22: Issue 1, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7

13101 Repair, complex, trunk; 2.6 cm to 7.5 cm FRVU 7.32 NFRVU 11.24 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: JUN 2017; Vol 27: Issue 4, DEC 2012; Vol 22: Issue 12, MAY 2011; Vol 21: Issue 5, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, JUL 2000; Vol 10: Issue 7

13102 Repair, complex, trunk; each additional 5 cm or less (List separately in addition to code for primary procedure) FRVU 2.15 NFRVU 3.45 GD ZZZ MUE 9 MOD 51, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: JUN 2017; Vol 27: Issue 4, DEC 2012; Vol 22: Issue 12, MAY 2011; Vol 21: Issue 5, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, JUL 2000; Vol 10: Issue 7

13120 Repair, complex, scalp, arms, and/or legs; 1.1 cm to 2.5 cm FRVU 6.82 NFRVU 9.94 GD 010 MUE 1 MOD 22, 51, 52, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7

13121 Repair, complex, scalp, arms, and/or legs; 2.6 cm to 7.5 cm FRVU 7.73 NFRVU 12.13 GD 010 MUE 1 MOD 51, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: MAY 2011; Vol 21: Issue 5, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, JAN 2002; Vol 12: Issue 1, FEB 2000; Vol 10: Issue 2, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7

13122 Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure) FRVU 2.48 NFRVU 3.79 GD ZZZ MUE 9 MOD 51, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, JUL 2000; Vol 10: Issue 7

13131 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 1.1 cm to 2.5 cm FRVU 7.23 NFRVU 10.95 GD 010 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5052CPT® Asst: JUN 2017; Vol 27: Issue 4, JAN 2013; Vol 23: Issue 1, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, FEB 2000; Vol 10: Issue 2, APR 2000; Vol 10: Issue 4, JUL 2000; Vol 10: Issue 7

13132 Repair, complex, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; 2.6 cm to 7.5 cm FRVU 9.11 NFRVU 13.53 GD 010 MUE 1 MOD 51, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: JUN 2017; Vol 27: Issue 4, OCT 2014; Vol 24: Issue 10, JAN 2013; Vol 23: Issue 1, MAY 2011; Vol 21: Issue 5, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

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) FRVU 3.81 NFRVU 5.09 GD ZZZ MUE 7 MOD 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No

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CPT® Asst: JUN 2017; Vol 27: Issue 4, JAN 2013; Vol 23: Issue 1, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, JUL 2000; Vol 10: Issue 7

13151 Repair, complex, eyelids, nose, ears and/or lips; 1.1 cm to 2.5 cm FRVU 8.31 NFRVU 12.00 GD 010 MUE 1 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: MAR 2014; Vol 24: Issue 3, MAY 2014; Vol 24: Issue 5, MAY 2014; Vol 24: Issue 5, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, JUL 2000; Vol 10: Issue 7

13152 Repair, complex, eyelids, nose, ears and/or lips; 2.6 cm to 7.5 cm FRVU 10.08 NFRVU 14.40 GD 010 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: MAR 2014; Vol 24: Issue 3, MAY 2014; Vol 24: Issue 5, MAY 2014; Vol 24: Issue 5, OCT 2014; Vol 24: Issue 10, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, FEB 2000; Vol 10: Issue 2, JUL 2000; Vol 10: Issue 7

13153 Repair, complex, eyelids, nose, ears and/or lips; each additional 5 cm or less (List separately in addition to code for primary procedure) FRVU 4.10 NFRVU 5.53 GD ZZZ MUE 2 MOD 22, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: MAR 2014; Vol 24: Issue 3, MAY 2014; Vol 24: Issue 5, MAY 2014; Vol 24: Issue 5, JAN 2012; Vol 22: Issue 1, MAY 2011; Vol 21: Issue 5, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4, JUL 2000; Vol 10: Issue 7

13160 Secondary closure of surgical wound or dehiscence, extensive or complicated FRVU 23.08 NFRVU 23.08 GD 090 MUE 2 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: MAY 2011; Vol 21: Issue 5, APR 2000; Vol 10: Issue 4

Adjacent Tissue Transfer or Rearrangement Procedures on the Integumentary System (14000-14350)14000 Adjacent tissue transfer or rearrangement, trunk; defect

10 sq cm or less FRVU 14.45 NFRVU 17.70 GD 090 MUE 2 MOD 51, 52, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: DEC 2017; Vol 27: Issue 10, FEB 2015; Vol 25: Issue 2, DEC 2015; Vol 25: Issue 9, APR 2014; Vol 24: Issue 4, JAN 2012; Vol 22: Issue 1, MAY 2012; Vol 22: Issue 5, NOV 2012; Vol 22: Issue 11, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, APR 2010; Vol 20: Issue 4, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14001 Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm FRVU 18.90 NFRVU 22.85 GD 090 MUE 2 MOD 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: DEC 2017; Vol 27: Issue 10, FEB 2015; Vol 25: Issue 2, APR 2014; Vol 24: Issue 4, JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14020 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10 sq cm or less FRVU 16.35 NFRVU 19.82 GD 090 MUE 4 MOD 51, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7

Z- Plasty Treatment

Flap-1

Flap-2

Tissue transfer from one place

to another(10 sq cm or less)

Wound is sutured

14021 Adjacent tissue transfer or rearrangement, scalp, arms and/or legs; defect 10.1 sq cm to 30.0 sq cm FRVU 20.71 NFRVU 24.81 GD 090 MUE 3 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14040 Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less

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FRVU 18.21 NFRVU 21.69 GD 090 MUE 4 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2018; Vol 27: Issue 9, JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

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 FRVU 22.46 NFRVU 26.89 GD 090 MUE 3 MOD 51, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2018; Vol 27: Issue 9, JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14060 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10 sq cm or less FRVU 19.40 NFRVU 22.13 GD 090 MUE 4 MOD 51, 53, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2018; Vol 27: Issue 9, JAN 2012; Vol 22: Issue 1, AUG 2012; Vol 22: Issue 8, NOV 2012; Vol 22: Issue 11, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14061 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10.1 sq cm to 30.0 sq cm FRVU 24.03 NFRVU 28.93 GD 090 MUE 2 MOD 51, 52, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2018; Vol 27: Issue 9, JAN 2012; Vol 22: Issue 1, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, DEC 2006; Vol 16: Issue 12, JUL 2000; Vol 10: Issue 7, AUG 2000; Vol 10: Issue 8

14301 Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm FRVU 25.44 NFRVU 30.71 GD 090 MUE 2 MOD 47, 51, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 80, 81, 82, 99, AS, GC, GR, KX, P1, P2, P3, P4, P5, P6, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: G2 ASC Sep. Pay: Yes APC SI: T APC: 5055CPT® Asst: JAN 2018; Vol 27: Issue 9, JUN 2017; Vol 27: Issue 4, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3

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) FRVU 6.40 NFRVU 6.40 GD ZZZ MUE 8 MOD 47, 53, 58, 59, 76, 77, 78, 79, 80, 81, 82, AS, GC, GJ, GR, KX, PD, Q5, Q6, QJ, XE, XP, XS, XU

ASC PI: N1 ASC Sep. Pay: No CPT® Asst: JAN 2018; Vol 27: Issue 9, NOV 2012; Vol 22: Issue 11, DEC 2012; Vol 22: Issue 12, MAR 2010; Vol 20: Issue 3, APR 2010; Vol 20: Issue 4

14350 Filleted finger or toe flap, including preparation of recipient site FRVU 19.72 NFRVU 19.72 GD 090 MUE 2 MOD 22, 47, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: MAY 2012; Vol 22: Issue 5, MAR 2010; Vol 20: Issue 3, JUL 2008; Vol 18: Issue 7, JAN 2006; Vol 16: Issue 1, AUG 2000; Vol 10: Issue 8

Skin Replacement Surgery (15002-15278)

Surgical Preparation for Skin Replacement Surgery (15002-15005)15002 Surgical preparation or creation of recipient site by

excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; first 100 sq cm or 1% of body area of infants and children FRVU 6.55 NFRVU 9.88 GD 000 MUE 1 MOD 47, 58, 59, 76, 77, 78, 79, 99, AQ, AR, ET, GA, GC, GJ, GR, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: DEC 2016; Vol 26: Issue 10, MAR 2014; Vol 24: Issue 3, FEB 2013; Vol 23: Issue 2, JAN 2012; Vol 22: Issue 1, OCT 2012; Vol 22: Issue 10, OCT 2012; Vol 22: Issue 10, DEC 2012; Vol 22: Issue 12, FEB 2010; Vol 20: Issue 2, APR 2010; Vol 20: Issue 4

15003 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, trunk, arms, legs; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure) FRVU 1.32 NFRVU 2.15 GD ZZZ MUE 60 MOD 47, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: DEC 2016; Vol 26: Issue 10, MAR 2014; Vol 24: Issue 3, FEB 2013; Vol 23: Issue 2, JAN 2012; Vol 22: Issue 1

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Defected area of recipient

(burn) on trunk

Skin is graftedon defected

area (each additional

100 sq cm or partthereof or 1%of body areof infants

and children)

Skin Replacement Surgery

15004 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; first 100 sq cm or 1% of body area of infants and children FRVU 7.78 NFRVU 11.39 GD 000 MUE 1 MOD 47, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: DEC 2016; Vol 26: Issue 10, MAR 2014; Vol 24: Issue 3, FEB 2013; Vol 23: Issue 2, JAN 2012; Vol 22: Issue 1

15005 Surgical preparation or creation of recipient site by excision of open wounds, burn eschar, or scar (including subcutaneous tissues), or incisional release of scar contracture, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet and/or multiple digits; each additional 100 sq cm, or part thereof, or each additional 1% of body area of infants and children (List separately in addition to code for primary procedure) FRVU 2.64 NFRVU 3.56 GD ZZZ MUE 19 MOD 22, 47, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, E1, E2, E3, E4, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: DEC 2016; Vol 26: Issue 10, MAR 2014; Vol 24: Issue 3, FEB 2013; Vol 23: Issue 2, JAN 2012; Vol 22: Issue 1, OCT 2012; Vol 22: Issue 10, OCT 2012; Vol 22: Issue 10, APR 2010; Vol 20: Issue 4

Autografts/Tissue Cultured Autograft (15040-15261)15040 Harvest of skin for tissue cultured skin autograft,

100 sq cm or less FRVU 3.68 NFRVU 7.22 GD 000 MUE 1

MOD 22, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, JC, JD, KX, PD, Q5, Q6, QJ, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: JAN 2012; Vol 22: Issue 1, APR 2010; Vol 20: Issue 4, FEB 2008; Vol 18: Issue 2, AUG 2006; Vol 16: Issue 8, OCT 2006; Vol 16: Issue 10

15050 Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter FRVU 12.73 NFRVU 15.94 GD 090 MUE 1 MOD 22, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, F1, F2, F3, F4, F5, F6, F7, F8, F9, FA, GA, GC, GJ, GR, JC, JD, KX, PD, Q5, Q6, QJ, T1, T2, T3, T4, T5, T6, T7, T8, T9, TA, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5053CPT® Asst: AUG 2016; Vol 26: Issue 6, MAR 2011; Vol 21: Issue 3

15100 Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) FRVU 20.58 NFRVU 24.45 GD 090 MUE 1 MOD 51, 53, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: AUG 2016; Vol 26: Issue 6, JAN 2012; Vol 22: Issue 1, OCT 2012; Vol 22: Issue 10, MAR 2011; Vol 21: Issue 3, FEB 2008; Vol 18: Issue 2, OCT 2006; Vol 16: Issue 10, SEP 2002; Vol 12: Issue 9

15101 Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) FRVU 3.21 NFRVU 5.29 GD ZZZ MUE 40 MOD 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: AUG 2016; Vol 26: Issue 6, MAR 2011; Vol 21: Issue 3, FEB 2008; Vol 18: Issue 2, SEP 2002; Vol 12: Issue 9

15110 Epidermal autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children FRVU 19.84 NFRVU 22.68 GD 090 MUE 1 MOD 22, 51, 52, 53, 54, 55, 56, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: A2 ASC Sep. Pay: Yes APC SI: T APC: 5054CPT® Asst: MAR 2011; Vol 21: Issue 3, FEB 2008; Vol 18: Issue 2

15111 Epidermal autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) FRVU 2.99 NFRVU 3.31 GD ZZZ MUE 5 MOD 22, 52, 53, 58, 59, 76, 77, 78, 79, 99, AQ, AR, GA, GC, GJ, GR, JC, JD, KX, LT, PD, Q5, Q6, QJ, RT, XE, XP, XS, XUASC PI: N1 ASC Sep. Pay: No CPT® Asst: MAR 2011; Vol 21: Issue 3, FEB 2008; Vol 18: Issue 2

15115 Epidermal autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children FRVU 20.03 NFRVU 22.87 GD 090 MUE 1

11470 - 11623 surgery/integumentary system...surgery/integumentary sy s tem 11470 - 11623 11470 -...

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