ICD-10-CM/PCS MS-DRG v39.1 Definitions Manual

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MDC 11 Diseases and disorders of the kidney and urinary tract
Kidney and ureter procedures
Page 1 of 4
Neoplasm MCC CC DRG
Yes Yes n/a 656
Yes No Yes 657
Yes No No 658
No Yes n/a 659
No No Yes 660
No No No 661

DRG 656 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC

DRG 657 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC

DRG 658 KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC

DRG 659 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC

DRG 660 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC

DRG 661 KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC

KIDNEY AND URETER PROCEDURES

OPERATING ROOM PROCEDURES

0410093Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Open Approach
0410094Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Open Approach
0410095Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach
04100A3Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Open Approach
04100A4Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Open Approach
04100A5Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach
04100J1Bypass Abdominal Aorta to Celiac Artery with Synthetic Substitute, Open Approach
04100J2Bypass Abdominal Aorta to Mesenteric Artery with Synthetic Substitute, Open Approach
04100J3Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Open Approach
04100J4Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Open Approach
04100J5Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Open Approach
04100K3Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach
04100K4Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach
04100K5Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach
04100Z1Bypass Abdominal Aorta to Celiac Artery, Open Approach
04100Z2Bypass Abdominal Aorta to Mesenteric Artery, Open Approach
04100Z3Bypass Abdominal Aorta to Right Renal Artery, Open Approach
04100Z4Bypass Abdominal Aorta to Left Renal Artery, Open Approach
04100Z5Bypass Abdominal Aorta to Bilateral Renal Artery, Open Approach
0410493Bypass Abdominal Aorta to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0410494Bypass Abdominal Aorta to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0410495Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
04104A3Bypass Abdominal Aorta to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04104A4Bypass Abdominal Aorta to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04104A5Bypass Abdominal Aorta to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04104J3Bypass Abdominal Aorta to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04104J4Bypass Abdominal Aorta to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04104J5Bypass Abdominal Aorta to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04104K3Bypass Abdominal Aorta to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K4Bypass Abdominal Aorta to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104K5Bypass Abdominal Aorta to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04104Z3Bypass Abdominal Aorta to Right Renal Artery, Percutaneous Endoscopic Approach
04104Z4Bypass Abdominal Aorta to Left Renal Artery, Percutaneous Endoscopic Approach
04104Z5Bypass Abdominal Aorta to Bilateral Renal Artery, Percutaneous Endoscopic Approach
0413093Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Open Approach
0413094Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Open Approach
0413095Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Open Approach
04130A3Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Open Approach
04130A4Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Open Approach
04130A5Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Open Approach
04130J3Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Open Approach
04130J4Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Open Approach
04130J5Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach
04130K3Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Open Approach
04130K4Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Open Approach
04130K5Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Open Approach
04130Z3Bypass Hepatic Artery to Right Renal Artery, Open Approach
04130Z4Bypass Hepatic Artery to Left Renal Artery, Open Approach
04130Z5Bypass Hepatic Artery to Bilateral Renal Artery, Open Approach
0413493Bypass Hepatic Artery to Right Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0413494Bypass Hepatic Artery to Left Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
0413495Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach
04134A3Bypass Hepatic Artery to Right Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04134A4Bypass Hepatic Artery to Left Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04134A5Bypass Hepatic Artery to Bilateral Renal Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach
04134J3Bypass Hepatic Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04134J4Bypass Hepatic Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04134J5Bypass Hepatic Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
04134K3Bypass Hepatic Artery to Right Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04134K4Bypass Hepatic Artery to Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04134K5Bypass Hepatic Artery to Bilateral Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
04134Z3Bypass Hepatic Artery to Right Renal Artery, Percutaneous Endoscopic Approach
04134Z4Bypass Hepatic Artery to Left Renal Artery, Percutaneous Endoscopic Approach
04134Z5Bypass Hepatic Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach
041C0J3Bypass Right Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Open Approach
041C0J4Bypass Right Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Open Approach
041C0J5Bypass Right Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach
041C0Z3Bypass Right Common Iliac Artery to Right Renal Artery, Open Approach
041C0Z4Bypass Right Common Iliac Artery to Left Renal Artery, Open Approach
041C0Z5Bypass Right Common Iliac Artery to Bilateral Renal Artery, Open Approach
041C4J3Bypass Right Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041C4J4Bypass Right Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041C4J5Bypass Right Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041C4Z3Bypass Right Common Iliac Artery to Right Renal Artery, Percutaneous Endoscopic Approach
041C4Z4Bypass Right Common Iliac Artery to Left Renal Artery, Percutaneous Endoscopic Approach
041C4Z5Bypass Right Common Iliac Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach
041D0J3Bypass Left Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Open Approach
041D0J4Bypass Left Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Open Approach
041D0J5Bypass Left Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Open Approach
041D0Z3Bypass Left Common Iliac Artery to Right Renal Artery, Open Approach
041D0Z4Bypass Left Common Iliac Artery to Left Renal Artery, Open Approach
041D0Z5Bypass Left Common Iliac Artery to Bilateral Renal Artery, Open Approach
041D4J3Bypass Left Common Iliac Artery to Right Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041D4J4Bypass Left Common Iliac Artery to Left Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041D4J5Bypass Left Common Iliac Artery to Bilateral Renal Artery with Synthetic Substitute, Percutaneous Endoscopic Approach
041D4Z3Bypass Left Common Iliac Artery to Right Renal Artery, Percutaneous Endoscopic Approach
041D4Z4Bypass Left Common Iliac Artery to Left Renal Artery, Percutaneous Endoscopic Approach
041D4Z5Bypass Left Common Iliac Artery to Bilateral Renal Artery, Percutaneous Endoscopic Approach
04S90ZZReposition Right Renal Artery, Open Approach
04S93ZZReposition Right Renal Artery, Percutaneous Approach
04S94ZZReposition Right Renal Artery, Percutaneous Endoscopic Approach
04SA0ZZReposition Left Renal Artery, Open Approach
04SA3ZZReposition Left Renal Artery, Percutaneous Approach
04SA4ZZReposition Left Renal Artery, Percutaneous Endoscopic Approach
06S90ZZReposition Right Renal Vein, Open Approach
06S93ZZReposition Right Renal Vein, Percutaneous Approach
06S94ZZReposition Right Renal Vein, Percutaneous Endoscopic Approach
06SB0ZZReposition Left Renal Vein, Open Approach
06SB3ZZReposition Left Renal Vein, Percutaneous Approach
06SB4ZZReposition Left Renal Vein, Percutaneous Endoscopic Approach
07T80ZZResection of Right Internal Mammary Lymphatic, Open Approach
07T84ZZResection of Right Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
07T90ZZResection of Left Internal Mammary Lymphatic, Open Approach
07T94ZZResection of Left Internal Mammary Lymphatic, Percutaneous Endoscopic Approach
07TC0ZZResection of Pelvis Lymphatic, Open Approach
07TC4ZZResection of Pelvis Lymphatic, Percutaneous Endoscopic Approach
07TD0ZZResection of Aortic Lymphatic, Open Approach
07TD4ZZResection of Aortic Lymphatic, Percutaneous Endoscopic Approach
07TH0ZZResection of Right Inguinal Lymphatic, Open Approach
07TH4ZZResection of Right Inguinal Lymphatic, Percutaneous Endoscopic Approach
07TJ0ZZResection of Left Inguinal Lymphatic, Open Approach
07TJ4ZZResection of Left Inguinal Lymphatic, Percutaneous Endoscopic Approach
0T13073Bypass Right Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Open Approach
0T13074Bypass Right Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Open Approach
0T13076Bypass Right Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Open Approach
0T13077Bypass Right Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Open Approach
0T13078Bypass Right Kidney Pelvis to Colon with Autologous Tissue Substitute, Open Approach
0T13079Bypass Right Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Open Approach
0T1307ABypass Right Kidney Pelvis to Ileum with Autologous Tissue Substitute, Open Approach
0T1307BBypass Right Kidney Pelvis to Bladder with Autologous Tissue Substitute, Open Approach
0T1307CBypass Right Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Open Approach
0T1307DBypass Right Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Open Approach
0T130J3Bypass Right Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Open Approach
0T130J4Bypass Right Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Open Approach
0T130J6Bypass Right Kidney Pelvis to Right Ureter with Synthetic Substitute, Open Approach
0T130J7Bypass Right Kidney Pelvis to Left Ureter with Synthetic Substitute, Open Approach
0T130J8Bypass Right Kidney Pelvis to Colon with Synthetic Substitute, Open Approach
0T130J9Bypass Right Kidney Pelvis to Colocutaneous with Synthetic Substitute, Open Approach
0T130JABypass Right Kidney Pelvis to Ileum with Synthetic Substitute, Open Approach
0T130JBBypass Right Kidney Pelvis to Bladder with Synthetic Substitute, Open Approach
0T130JCBypass Right Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Open Approach
0T130JDBypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Open Approach
0T130K3Bypass Right Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach
0T130K4Bypass Right Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach
0T130K6Bypass Right Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Open Approach
0T130K7Bypass Right Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Open Approach
0T130K8Bypass Right Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Open Approach
0T130K9Bypass Right Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Open Approach
0T130KABypass Right Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Open Approach
0T130KBBypass Right Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Open Approach
0T130KCBypass Right Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach
0T130KDBypass Right Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Open Approach
0T130Z3Bypass Right Kidney Pelvis to Right Kidney Pelvis, Open Approach
0T130Z4Bypass Right Kidney Pelvis to Left Kidney Pelvis, Open Approach
0T130Z6Bypass Right Kidney Pelvis to Right Ureter, Open Approach
0T130Z7Bypass Right Kidney Pelvis to Left Ureter, Open Approach
0T130Z8Bypass Right Kidney Pelvis to Colon, Open Approach
0T130Z9Bypass Right Kidney Pelvis to Colocutaneous, Open Approach
0T130ZABypass Right Kidney Pelvis to Ileum, Open Approach
0T130ZBBypass Right Kidney Pelvis to Bladder, Open Approach
0T130ZCBypass Right Kidney Pelvis to Ileocutaneous, Open Approach
0T130ZDBypass Right Kidney Pelvis to Cutaneous, Open Approach
0T133JDBypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Approach
0T13473Bypass Right Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T13474Bypass Right Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T13476Bypass Right Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T13477Bypass Right Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T13478Bypass Right Kidney Pelvis to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T13479Bypass Right Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1347ABypass Right Kidney Pelvis to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1347BBypass Right Kidney Pelvis to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1347CBypass Right Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1347DBypass Right Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134J3Bypass Right Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134J4Bypass Right Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134J6Bypass Right Kidney Pelvis to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134J7Bypass Right Kidney Pelvis to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134J8Bypass Right Kidney Pelvis to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134J9Bypass Right Kidney Pelvis to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134JABypass Right Kidney Pelvis to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134JBBypass Right Kidney Pelvis to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134JCBypass Right Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134JDBypass Right Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T134K3Bypass Right Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134K4Bypass Right Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134K6Bypass Right Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134K7Bypass Right Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134K8Bypass Right Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134K9Bypass Right Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134KABypass Right Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134KBBypass Right Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134KCBypass Right Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134KDBypass Right Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T134Z3Bypass Right Kidney Pelvis to Right Kidney Pelvis, Percutaneous Endoscopic Approach
0T134Z4Bypass Right Kidney Pelvis to Left Kidney Pelvis, Percutaneous Endoscopic Approach
0T134Z6Bypass Right Kidney Pelvis to Right Ureter, Percutaneous Endoscopic Approach
0T134Z7Bypass Right Kidney Pelvis to Left Ureter, Percutaneous Endoscopic Approach
0T134Z8Bypass Right Kidney Pelvis to Colon, Percutaneous Endoscopic Approach
0T134Z9Bypass Right Kidney Pelvis to Colocutaneous, Percutaneous Endoscopic Approach
0T134ZABypass Right Kidney Pelvis to Ileum, Percutaneous Endoscopic Approach
0T134ZBBypass Right Kidney Pelvis to Bladder, Percutaneous Endoscopic Approach
0T134ZCBypass Right Kidney Pelvis to Ileocutaneous, Percutaneous Endoscopic Approach
0T134ZDBypass Right Kidney Pelvis to Cutaneous, Percutaneous Endoscopic Approach
0T14073Bypass Left Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Open Approach
0T14074Bypass Left Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Open Approach
0T14076Bypass Left Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Open Approach
0T14077Bypass Left Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Open Approach
0T14078Bypass Left Kidney Pelvis to Colon with Autologous Tissue Substitute, Open Approach
0T14079Bypass Left Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Open Approach
0T1407ABypass Left Kidney Pelvis to Ileum with Autologous Tissue Substitute, Open Approach
0T1407BBypass Left Kidney Pelvis to Bladder with Autologous Tissue Substitute, Open Approach
0T1407CBypass Left Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Open Approach
0T1407DBypass Left Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Open Approach
0T140J3Bypass Left Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Open Approach
0T140J4Bypass Left Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Open Approach
0T140J6Bypass Left Kidney Pelvis to Right Ureter with Synthetic Substitute, Open Approach
0T140J7Bypass Left Kidney Pelvis to Left Ureter with Synthetic Substitute, Open Approach
0T140J8Bypass Left Kidney Pelvis to Colon with Synthetic Substitute, Open Approach
0T140J9Bypass Left Kidney Pelvis to Colocutaneous with Synthetic Substitute, Open Approach
0T140JABypass Left Kidney Pelvis to Ileum with Synthetic Substitute, Open Approach
0T140JBBypass Left Kidney Pelvis to Bladder with Synthetic Substitute, Open Approach
0T140JCBypass Left Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Open Approach
0T140JDBypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Open Approach
0T140K3Bypass Left Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach
0T140K4Bypass Left Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Open Approach
0T140K6Bypass Left Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Open Approach
0T140K7Bypass Left Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Open Approach
0T140K8Bypass Left Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Open Approach
0T140K9Bypass Left Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Open Approach
0T140KABypass Left Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Open Approach
0T140KBBypass Left Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Open Approach
0T140KCBypass Left Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach
0T140KDBypass Left Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Open Approach
0T140Z3Bypass Left Kidney Pelvis to Right Kidney Pelvis, Open Approach
0T140Z4Bypass Left Kidney Pelvis to Left Kidney Pelvis, Open Approach
0T140Z6Bypass Left Kidney Pelvis to Right Ureter, Open Approach
0T140Z7Bypass Left Kidney Pelvis to Left Ureter, Open Approach
0T140Z8Bypass Left Kidney Pelvis to Colon, Open Approach
0T140Z9Bypass Left Kidney Pelvis to Colocutaneous, Open Approach
0T140ZABypass Left Kidney Pelvis to Ileum, Open Approach
0T140ZBBypass Left Kidney Pelvis to Bladder, Open Approach
0T140ZCBypass Left Kidney Pelvis to Ileocutaneous, Open Approach
0T140ZDBypass Left Kidney Pelvis to Cutaneous, Open Approach
0T143JDBypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Approach
0T14473Bypass Left Kidney Pelvis to Right Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T14474Bypass Left Kidney Pelvis to Left Kidney Pelvis with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T14476Bypass Left Kidney Pelvis to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T14477Bypass Left Kidney Pelvis to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T14478Bypass Left Kidney Pelvis to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T14479Bypass Left Kidney Pelvis to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1447ABypass Left Kidney Pelvis to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1447BBypass Left Kidney Pelvis to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1447CBypass Left Kidney Pelvis to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1447DBypass Left Kidney Pelvis to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144J3Bypass Left Kidney Pelvis to Right Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144J4Bypass Left Kidney Pelvis to Left Kidney Pelvis with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144J6Bypass Left Kidney Pelvis to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144J7Bypass Left Kidney Pelvis to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144J8Bypass Left Kidney Pelvis to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144J9Bypass Left Kidney Pelvis to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144JABypass Left Kidney Pelvis to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144JBBypass Left Kidney Pelvis to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144JCBypass Left Kidney Pelvis to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144JDBypass Left Kidney Pelvis to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T144K3Bypass Left Kidney Pelvis to Right Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144K4Bypass Left Kidney Pelvis to Left Kidney Pelvis with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144K6Bypass Left Kidney Pelvis to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144K7Bypass Left Kidney Pelvis to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144K8Bypass Left Kidney Pelvis to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144K9Bypass Left Kidney Pelvis to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144KABypass Left Kidney Pelvis to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144KBBypass Left Kidney Pelvis to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144KCBypass Left Kidney Pelvis to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144KDBypass Left Kidney Pelvis to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T144Z3Bypass Left Kidney Pelvis to Right Kidney Pelvis, Percutaneous Endoscopic Approach
0T144Z4Bypass Left Kidney Pelvis to Left Kidney Pelvis, Percutaneous Endoscopic Approach
0T144Z6Bypass Left Kidney Pelvis to Right Ureter, Percutaneous Endoscopic Approach
0T144Z7Bypass Left Kidney Pelvis to Left Ureter, Percutaneous Endoscopic Approach
0T144Z8Bypass Left Kidney Pelvis to Colon, Percutaneous Endoscopic Approach
0T144Z9Bypass Left Kidney Pelvis to Colocutaneous, Percutaneous Endoscopic Approach
0T144ZABypass Left Kidney Pelvis to Ileum, Percutaneous Endoscopic Approach
0T144ZBBypass Left Kidney Pelvis to Bladder, Percutaneous Endoscopic Approach
0T144ZCBypass Left Kidney Pelvis to Ileocutaneous, Percutaneous Endoscopic Approach
0T144ZDBypass Left Kidney Pelvis to Cutaneous, Percutaneous Endoscopic Approach
0T16076Bypass Right Ureter to Right Ureter with Autologous Tissue Substitute, Open Approach
0T16077Bypass Right Ureter to Left Ureter with Autologous Tissue Substitute, Open Approach
0T16078Bypass Right Ureter to Colon with Autologous Tissue Substitute, Open Approach
0T16079Bypass Right Ureter to Colocutaneous with Autologous Tissue Substitute, Open Approach
0T1607ABypass Right Ureter to Ileum with Autologous Tissue Substitute, Open Approach
0T1607BBypass Right Ureter to Bladder with Autologous Tissue Substitute, Open Approach
0T1607CBypass Right Ureter to Ileocutaneous with Autologous Tissue Substitute, Open Approach
0T1607DBypass Right Ureter to Cutaneous with Autologous Tissue Substitute, Open Approach
0T160J6Bypass Right Ureter to Right Ureter with Synthetic Substitute, Open Approach
0T160J7Bypass Right Ureter to Left Ureter with Synthetic Substitute, Open Approach
0T160J8Bypass Right Ureter to Colon with Synthetic Substitute, Open Approach
0T160J9Bypass Right Ureter to Colocutaneous with Synthetic Substitute, Open Approach
0T160JABypass Right Ureter to Ileum with Synthetic Substitute, Open Approach
0T160JBBypass Right Ureter to Bladder with Synthetic Substitute, Open Approach
0T160JCBypass Right Ureter to Ileocutaneous with Synthetic Substitute, Open Approach
0T160JDBypass Right Ureter to Cutaneous with Synthetic Substitute, Open Approach
0T160K6Bypass Right Ureter to Right Ureter with Nonautologous Tissue Substitute, Open Approach
0T160K7Bypass Right Ureter to Left Ureter with Nonautologous Tissue Substitute, Open Approach
0T160K8Bypass Right Ureter to Colon with Nonautologous Tissue Substitute, Open Approach
0T160K9Bypass Right Ureter to Colocutaneous with Nonautologous Tissue Substitute, Open Approach
0T160KABypass Right Ureter to Ileum with Nonautologous Tissue Substitute, Open Approach
0T160KBBypass Right Ureter to Bladder with Nonautologous Tissue Substitute, Open Approach
0T160KCBypass Right Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach
0T160KDBypass Right Ureter to Cutaneous with Nonautologous Tissue Substitute, Open Approach
0T160Z6Bypass Right Ureter to Right Ureter, Open Approach
0T160Z7Bypass Right Ureter to Left Ureter, Open Approach
0T160Z8Bypass Right Ureter to Colon, Open Approach
0T160Z9Bypass Right Ureter to Colocutaneous, Open Approach
0T160ZABypass Right Ureter to Ileum, Open Approach
0T160ZBBypass Right Ureter to Bladder, Open Approach
0T160ZCBypass Right Ureter to Ileocutaneous, Open Approach
0T160ZDBypass Right Ureter to Cutaneous, Open Approach
0T163JDBypass Right Ureter to Cutaneous with Synthetic Substitute, Percutaneous Approach
0T16476Bypass Right Ureter to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T16477Bypass Right Ureter to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T16478Bypass Right Ureter to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T16479Bypass Right Ureter to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1647ABypass Right Ureter to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1647BBypass Right Ureter to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1647CBypass Right Ureter to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1647DBypass Right Ureter to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164J6Bypass Right Ureter to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164J7Bypass Right Ureter to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164J8Bypass Right Ureter to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164J9Bypass Right Ureter to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164JABypass Right Ureter to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164JBBypass Right Ureter to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164JCBypass Right Ureter to Ileocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164JDBypass Right Ureter to Cutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T164K6Bypass Right Ureter to Right Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164K7Bypass Right Ureter to Left Ureter with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164K8Bypass Right Ureter to Colon with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164K9Bypass Right Ureter to Colocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164KABypass Right Ureter to Ileum with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164KBBypass Right Ureter to Bladder with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164KCBypass Right Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164KDBypass Right Ureter to Cutaneous with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
0T164Z6Bypass Right Ureter to Right Ureter, Percutaneous Endoscopic Approach
0T164Z7Bypass Right Ureter to Left Ureter, Percutaneous Endoscopic Approach
0T164Z8Bypass Right Ureter to Colon, Percutaneous Endoscopic Approach
0T164Z9Bypass Right Ureter to Colocutaneous, Percutaneous Endoscopic Approach
0T164ZABypass Right Ureter to Ileum, Percutaneous Endoscopic Approach
0T164ZBBypass Right Ureter to Bladder, Percutaneous Endoscopic Approach
0T164ZCBypass Right Ureter to Ileocutaneous, Percutaneous Endoscopic Approach
0T164ZDBypass Right Ureter to Cutaneous, Percutaneous Endoscopic Approach
0T17076Bypass Left Ureter to Right Ureter with Autologous Tissue Substitute, Open Approach
0T17077Bypass Left Ureter to Left Ureter with Autologous Tissue Substitute, Open Approach
0T17078Bypass Left Ureter to Colon with Autologous Tissue Substitute, Open Approach
0T17079Bypass Left Ureter to Colocutaneous with Autologous Tissue Substitute, Open Approach
0T1707ABypass Left Ureter to Ileum with Autologous Tissue Substitute, Open Approach
0T1707BBypass Left Ureter to Bladder with Autologous Tissue Substitute, Open Approach
0T1707CBypass Left Ureter to Ileocutaneous with Autologous Tissue Substitute, Open Approach
0T1707DBypass Left Ureter to Cutaneous with Autologous Tissue Substitute, Open Approach
0T170J6Bypass Left Ureter to Right Ureter with Synthetic Substitute, Open Approach
0T170J7Bypass Left Ureter to Left Ureter with Synthetic Substitute, Open Approach
0T170J8Bypass Left Ureter to Colon with Synthetic Substitute, Open Approach
0T170J9Bypass Left Ureter to Colocutaneous with Synthetic Substitute, Open Approach
0T170JABypass Left Ureter to Ileum with Synthetic Substitute, Open Approach
0T170JBBypass Left Ureter to Bladder with Synthetic Substitute, Open Approach
0T170JCBypass Left Ureter to Ileocutaneous with Synthetic Substitute, Open Approach
0T170JDBypass Left Ureter to Cutaneous with Synthetic Substitute, Open Approach
0T170K6Bypass Left Ureter to Right Ureter with Nonautologous Tissue Substitute, Open Approach
0T170K7Bypass Left Ureter to Left Ureter with Nonautologous Tissue Substitute, Open Approach
0T170K8Bypass Left Ureter to Colon with Nonautologous Tissue Substitute, Open Approach
0T170K9Bypass Left Ureter to Colocutaneous with Nonautologous Tissue Substitute, Open Approach
0T170KABypass Left Ureter to Ileum with Nonautologous Tissue Substitute, Open Approach
0T170KBBypass Left Ureter to Bladder with Nonautologous Tissue Substitute, Open Approach
0T170KCBypass Left Ureter to Ileocutaneous with Nonautologous Tissue Substitute, Open Approach
0T170KDBypass Left Ureter to Cutaneous with Nonautologous Tissue Substitute, Open Approach
0T170Z6Bypass Left Ureter to Right Ureter, Open Approach
0T170Z7Bypass Left Ureter to Left Ureter, Open Approach
0T170Z8Bypass Left Ureter to Colon, Open Approach
0T170Z9Bypass Left Ureter to Colocutaneous, Open Approach
0T170ZABypass Left Ureter to Ileum, Open Approach
0T170ZBBypass Left Ureter to Bladder, Open Approach
0T170ZCBypass Left Ureter to Ileocutaneous, Open Approach
0T170ZDBypass Left Ureter to Cutaneous, Open Approach
0T173JDBypass Left Ureter to Cutaneous with Synthetic Substitute, Percutaneous Approach
0T17476Bypass Left Ureter to Right Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T17477Bypass Left Ureter to Left Ureter with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T17478Bypass Left Ureter to Colon with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T17479Bypass Left Ureter to Colocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1747ABypass Left Ureter to Ileum with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1747BBypass Left Ureter to Bladder with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1747CBypass Left Ureter to Ileocutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T1747DBypass Left Ureter to Cutaneous with Autologous Tissue Substitute, Percutaneous Endoscopic Approach
0T174J6Bypass Left Ureter to Right Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T174J7Bypass Left Ureter to Left Ureter with Synthetic Substitute, Percutaneous Endoscopic Approach
0T174J8Bypass Left Ureter to Colon with Synthetic Substitute, Percutaneous Endoscopic Approach
0T174J9Bypass Left Ureter to Colocutaneous with Synthetic Substitute, Percutaneous Endoscopic Approach
0T174JABypass Left Ureter to Ileum with Synthetic Substitute, Percutaneous Endoscopic Approach
0T174JBBypass Left Ureter to Bladder with Synthetic Substitute, Percutaneous Endoscopic Approach



Centers for Medicare & Medicaid Services, 7500 Security Boulevard Baltimore, MD 21244
16 Mar 2022 16:20:17
CMS, code-revision=332, description-revision=1327