Page 1 of 30. Insertion of epicardial electrode(s); open incision (eg, thoracotomy, Insertion of epicardial electrode(s); endoscopic approach (eg,

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1 Page 1 of 30 Medicare IP Only List 2019 Cardiovascular System Removed from IP only list Added to IP only list Incision of heart sac Tube pericardiostomy Incision of heart sac Pericardiotomy for removal of clot or foreign body (primary procedure) Incision of heart sac Creation of pericardial window or partial resection for drainage Partial removal of heart sac Pericardiectomy, subtotal or complete; without cardiopulmonary bypass Partial removal of heart sac Pericardiectomy, subtotal or complete; with cardiopulmonary bypass Resect of heart sac lesion Excision of pericardial cyst or tumor Removal of heart lesion Excision of intracardiac tumor, resection with cardiopulmonary bypass Removal of heart lesion Resection of external cardiac tumor Transmyocardial laser revascularization, by thoracotomy; (separate Heart revascularize (tmr) procedure) Transmyocardial laser revascularization, by thoracotomy; performed at the time of other open cardiac procedure(s) (List separately in addition to Heart tmr w/other procedure code for primary procedure) Insertion of epicardial electrode(s); open incision (eg, thoracotomy, Insert epicard eltrd open median sternotomy, subxiphoid approach) Insertion of epicardial electrode(s); endoscopic approach (eg, Insert epicard eltrd endo thoracoscopy, pericardioscopy) Removal of permanent epicardial pacemaker and electrodes by Remove electrode/thoracotomy thoracotomy; single lead system, atrial or ventricular Removal of permanent epicardial pacemaker and electrodes by Remove electrode/thoracotomy thoracotomy; dual lead system Remove electrode/thoracotomy Removal of permanent transvenous electrode(s) by thoracotomy Removal of single or dual chamber pacing cardioverter-defibrillator Remove eltrd/thoracotomy electrode(s); by thoracotomy Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) Ablate heart dysrhythm focus and/or focus (foci); without cardiopulmonary bypass Operative ablation of supraventricular arrhythmogenic focus or pathway (eg, Wolff-Parkinson-White, atrioventricular node re-entry), tract(s) Ablate heart dysrhythm focus and/or focus (foci); with cardiopulmonary bypass Operative tissue ablation and reconstruction of atria, limited (eg, Ablate atria lmtd modified maze procedure) Operative tissue ablation and reconstruction of atria, extensive (eg, Ablate atria w/o bypass ext maze procedure); without cardiopulmonary bypass

2 Page 2 of 30 Operative tissue ablation and reconstruction of atria, extensive (eg, Ablate atria w/bypass exten maze procedure); with cardiopulmonary bypass Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), limited (eg, modified maze Ablate atria lmtd add-on procedure) (list separately in addition to code for primary procedure) Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), without cardiopulmonary bypass (list separately in addition to code for Ablate atria x10sv add-on primary procedure) Operative tissue ablation and reconstruction of atria, performed at the time of other cardiac procedure(s), extensive (eg, maze procedure), with cardiopulmonary bypass (list separately in addition to code for primary Ablate atria w/bypass add-on procedure) Operative ablation of ventricular arrhythmogenic focus with Ablate heart dysrhythm focus cardiopulmonary bypass Endoscopy, surgical; operative tissue ablation and reconstruction of atria, limited (eg, modified maze procedure), without cardiopulmonary Ablate atria lmtd endo bypass Endoscopy, surgical; operative tissue ablation and reconstruction of Ablate atria x 10sv endo atria, extensive (eg, maze procedure), without cardiopulmonary bypass Repair of heart wound Repair of cardiac wound; without bypass Repair of heart wound Repair of cardiac wound; with cardiopulmonary bypass Cardiotomy, exploratory (includes removal of foreign body, atrial or Exploratory heart surgery ventricular thrombus); without bypass Cardiotomy, exploratory (includes removal of foreign body, atrial or Exploratory heart surgery ventricular thrombus); with cardiopulmonary bypass Suture repair of aorta or great vessels; without shunt or cardiopulmonary Repair major blood vessel(s) bypass Repair major vessel Suture repair of aorta or great vessels; with shunt bypass Repair major blood vessel(s) Suture repair of aorta or great vessels; with cardiopulmonary bypass Insertion of graft, aorta or great vessels; without shunt, or Insert major vessel graft cardiopulmonary bypass Insert major vessel graft Insertion of graft, aorta or great vessels; with cardiopulmonary bypass Percutaneous transcatheter closure of the left atrial appendage with endocardial implant, including fluoroscopy, transseptal puncture, catheter placement(s), left atrial angiography, left atrial appendage angiography, when performed, and radiological supervision and Perq clsr tcat l atr apndge interpretation Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic Replace aortic valve perq valve; percutaneous femoral artery approach

3 Page 3 of 30 Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic Replace aortic valve open valve; open femoral artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic Replace aortic valve open valve; open axillary artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic Replace aortic valve open valve; open iliac artery approach Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic Replace aortic valve open valve; transaortic approach (eg, median sternotomy, mediastinotomy) Transcatheter aortic valve replacement (tavr/tavi) with prosthetic valve; Trcath replace aortic valve transapical exposure (eg, left thoracotomy) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with percutaneous peripheral arterial and venous cannulation (eg, femoral vessels) (List separately in Replace aortic valve w/byp addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with open peripheral arterial and venous cannulation (eg, femoral, iliac, axillary vessels) (List separately in Replace aortic valve w/byp addition to code for primary procedure) Transcatheter aortic valve replacement (TAVR/TAVI) with prosthetic valve; cardiopulmonary bypass support with central arterial and venous cannulation (eg, aorta, right atrium, pulmonary artery) (List separately in Replace aortic valve w/byp addition to code for primary procedure) Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; simple (ie, valvotomy, debridement, debulking, and/or simple commissural Valvuloplasty aortic valve resuspension) Valvuloplasty, aortic valve, open, with cardiopulmonary bypass; complex (eg, leaflet extension, leaflet resection, leaflet reconstruction, or Valvuloplasty aortic valve annuloplasty) Prepare heart-aorta conduit Construction of apical-aortic conduit Replacement, aortic valve, with cardiopulmonary bypass; with prosthetic Replacement of aortic valve valve other than homograft or stentless valve Replacement, aortic valve, with cardiopulmonary bypass; with allograft Replacement of aortic valve valve (freehand) Replacement, aortic valve, with cardiopulmonary bypass; with stentless Replacement of aortic valve tissue valve Replacement, aortic valve; with aortic annulus enlargement, Replacement of aortic valve noncoronary cusp Replacement, aortic valve; with transventricular aortic annulus Replacement of aortic valve enlargement (Konno procedure) Replacement, aortic valve; by translocation of autologous pulmonary Replacement of aortic valve valve with allograft replacement of pulmonary valve (Ross procedure)

4 Page 4 of 30 Repair of left ventricular outflow tract obstruction by patch enlargement Repair of aortic valve of the outflow tract Resection or incision of subvalvular tissue for discrete subvalvular aortic Revision subvalvular tissue stenosis Ventriculomyotomy (-myectomy) for idiopathic hypertrophic subaortic Revise ventricle muscle stenosis (eg, asymmetric septal hypertrophy) Repair of aortic valve Aortoplasty (gusset) for supravalvular stenosis Transcatheter mitral valve repair, percutaneous approach, including Repair tcat mitral valve transseptal puncture when performed; initial prosthesis Revision of mitral valve Valvotomy, mitral valve; closed heart Revision of mitral valve Valvotomy, mitral valve; open heart, with cardiopulmonary bypass Repair of mitral valve Valvuloplasty, mitral valve, with cardiopulmonary bypass; Valvuloplasty, mitral valve, with cardiopulmonary bypass; with prosthetic Repair of mitral valve ring Valvuloplasty, mitral valve, with cardiopulmonary bypass; radical Repair of mitral valve reconstruction, with or without ring Replacement of mitral valve Replacement, mitral valve, with cardiopulmonary bypass Replacement, aortic valve; by translocation of autologous pulmonary valve and transventricular aortic annulus enlargement of the left ventricular outflow tract with valved conduit replacement of pulmonary valve Replacement, aortic valve Revision of tricuspid valve Valvectomy, tricuspid valve, with cardiopulmonary bypass Valvuloplasty tricuspid Valvuloplasty, tricuspid valve; without ring insertion Valvuloplasty tricuspid Valvuloplasty, tricuspid valve; with ring insertion Replace tricuspid valve Replacement, tricuspid valve, with cardiopulmonary bypass Revision of tricuspid valve Tricuspid valve repositioning and plication for Ebstein anomaly Revision of pulmonary valve Valvotomy, pulmonary valve, closed heart; transventricular Valvotomy pulmonary valve Valvotomy, pulmonary valve, closed heart; via pulmonary artery Revision of pulmomary valve Valvotomy, pulmonary valve, open heart; with cardiopulmonary bypass Replacement pulmonary valve Replacement, pulmonary valve Revision of heart chamber Implant tcat pulm vlv perq Revision of heart chamber Repair prosth valve clot Repair heart vessel fistula Right ventricular resection for infundibular stenosis, with or without commissurotomy Transcatheter pulmonary valve implantation, percutaneous approach, including pre-stenting of the valve delivery site, when performed Outflow tract augmentation (gusset), with or without commissurotomy or infundibular resection Repair of non-structural prosthetic valve dysfunction with cardiopulmonary bypass (separate procedure) Repair of coronary arteriovenous or arteriocardiac chamber fistula; with cardiopulmonary bypass

5 Page 5 of 30 Repair of coronary arteriovenous or arteriocardiac chamber fistula; Repair heart vessel fistula without cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; by Coronary artery correction ligation Repair of anomalous coronary artery from pulmonary artery origin; by Coronary artery graft graft, without cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; by Coronary artery graft graft, with cardiopulmonary bypass Repair of anomalous coronary artery from pulmonary artery origin; with Repair artery w/tunnel construction of intrapulmonary artery tunnel (Takeuchi procedure) Repair of anomalous coronary artery from pulmonary artery origin; by Repair artery translocation translocation from pulmonary artery to aorta Repair of anomalous (eg, intramural) aortic origin of coronary artery by Repair art intramural unroofing or translocation Cabg vein single Coronary artery bypass, vein only; single coronary venous graft Cabg vein two Coronary artery bypass, vein only; two coronary venous grafts Cabg vein three Coronary artery bypass, vein only; three coronary venous grafts Cabg vein four Coronary artery bypass, vein only; four coronary venous grafts Cabg vein five Coronary artery bypass, vein only; five coronary venous grafts Cabg vein six or more Coronary artery bypass, vein only; six or more coronary venous grafts Coronary artery bypass, using venous graft(s) and arterial graft(s); Cabg artery-vein single single vein graft (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); two Cabg artery-vein two venous grafts (List separately in addition to code for arterial graft) Cabg artery-vein three Cabg artery-vein four Cabg artery-vein five Coronary artery bypass, using venous graft(s) and arterial graft(s); three venous grafts (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); four venous grafts (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); five venous grafts (List separately in addition to code for arterial graft) Coronary artery bypass, using venous graft(s) and arterial graft(s); six or Cabg art-vein six or more more venous grafts (List separately in addition to code for arterial graft) Reoperation, coronary artery bypass procedure or valve procedure, more than one month after original operation (List separately in addition Coronary artery bypass/rcop to code for primary procedure) Cabg arterial single Coronary artery bypass, using arterial graft(s); single arterial graft Coronary artery bypass, using arterial graft(s); two coronary arterial Cabg arterial two grafts

6 Page 6 of 30 Coronary artery bypass, using arterial graft(s); three coronary arterial Cabg arterial three grafts Coronary artery bypass, using arterial graft(s); four or more coronary Cabg arterial four or more arterial grafts Removal of heart lesion Myocardial resection (eg, ventricular aneurysmectomy) Repair of postinfarction ventricular septal defect, with or without Repair of heart damage myocardial resection Surgical ventricular restoration procedure, includes prosthetic patch, when performed (eg, ventricular remodeling, SVR, SAVER, DOR Restore/remodel ventricle procedures) Coronary endarterectomy, open, any method, of left anterior descending, circumflex, or right coronary artery performed in conjunction with coronary artery bypass graft procedure, each vessel (List separately Open coronary endarterectomy in addition to primary procedure) Closure of valve Closure of atrioventricular valve (mitral or tricuspid) by suture or patch Closure of valve Closure of semilunar valve (aortic or pulmonary) by suture or patch Anastomosis of pulmonary artery to aorta (Damus-Kaye-Stansel Anastomosis/artery-aorta procedure) Repair of complex cardiac anomaly other than pulmonary atresia with ventricular septal defect by construction or replacement of conduit from Repair anomaly w/conduit right or left ventricle to pulmonary artery Repair of complex cardiac anomalies (eg, single ventricle with subaortic Repair by enlargement obstruction) by surgical enlargement of ventricular septal defect Repair double ventricle Repair of double outlet right ventricle with intraventricular tunnel repair; Repair of double outlet right ventricle with intraventricular tunnel repair; Repair double ventricle with repair of right ventricular outflow tract obstruction Repair of complex cardiac anomalies (eg, tricuspid atresia) by closure of atrial septal defect and anastomosis of atria or vena cava to pulmonary Repair modified fontan artery (simple Fontan procedure) Repair of complex cardiac anomalies (eg, single ventricle) by modified Repair single ventricle Fontan procedure Repair of single ventricle with aortic outflow obstruction and aortic arch Repair single ventricle hypoplasia (hypoplastic left heart syndrome) (eg, Norwood procedure) Application of right and left pulmonary artery bands (eg, hybrid approach Apply r&l pulm art bands stage 1) Transthoracic insertion of catheter for stent placement with catheter Transthor cath for stent removal and closure (eg, hybrid approach stage 1)

7 Page 7 of 30 Reconstruction of complex cardiac anomaly (eg, single ventricle or hypoplastic left heart) with palliation of single ventricle with aortic outflow obstruction and aortic arch hypoplasia, creation of cavopulmonary anastomosis, and removal of right and left pulmonary bands (eg, hybrid approach stage 2, norwood, bidirectional glenn, pulmonary artery Redo compl cardiac anomaly debanding) Repair atrial septal defect, secundum, with cardiopulmonary bypass, Repair heart septum defect with or without patch Direct or patch closure, sinus venosus, with or without anomalous Revision of heart veins pulmonary venous drainage Repair of atrial septal defect and ventricular septal defect, with direct or Repair heart septum defects patch closure Repair of incomplete or partial atrioventricular canal (ostium primum Repair of heart defects atrial septal defect), with or without atrioventricular valve repair Repair of intermediate or transitional atrioventricular canal, with or Repair of heart defects without atrioventricular valve repair Repair of heart chambers Repair of complete atrioventricular canal, with or without prosthetic valve Close mult vsd Closure of multiple ventricular septal defects; Closure of multiple ventricular septal defects; with pulmonary valvotomy Close mult vsd w/resection or infundibular resection (acyanotic) Closure of multiple ventricular septal defects; with removal of pulmonary Cl mult vsd w/rem pul band artery band, with or without gusset Repair heart septum defect Closure of single ventricular septal defect, with or without patch; Closure of single ventricular septal defect, with or without patch; with Repair heart septum defect pulmonary valvotomy or infundibular resection (acyanotic) Closure of single ventricular septal defect, with or without patch; with Repair heart septum defect removal of pulmonary artery band, with or without gusset Reinforce pulmonary artery Banding of pulmonary artery Repair of heart defects Complete repair tetralogy of Fallot without pulmonary atresia; Complete repair tetralogy of Fallot without pulmonary atresia; with Repair of heart defects transannular patch Complete repair tetralogy of Fallot with pulmonary atresia including construction of conduit from right ventricle to pulmonary artery and Repair of heart defects closure of ventricular septal defect Repair of heart defects Repair sinus of Valsalva fistula, with cardiopulmonary bypass; Repair sinus of Valsalva fistula, with cardiopulmonary bypass; with repair Repair of heart defects of ventricular septal defect Repair of heart defect Repair sinus of Valsalva aneurysm, with cardiopulmonary bypass Repair of heart defect Closure of aortico-left ventricular tunnel

8 Page 8 of 30 Repair of isolated partial anomalous pulmonary venous return (eg, Repair venous anomaly Scimitar Syndrome) Repair pul venous stenosis Repair of pulmonary venous stenosis Complete repair of anomalous pulmonary venous return (supracardiac, Repair heart-vein defect(s) intracardiac, or infracardiac types) Repair of cor triatriatum or supravalvular mitral ring by resection of left Repair heart-vein defect atrial membrane Atrial septectomy or septostomy; closed heart (Blalock-Hanlon type Revision of heart chamber operation) Atrial septectomy or septostomy; open heart with cardiopulmonary Revision of heart chamber bypass Revision of heart chamber Atrial septectomy or septostomy; open heart, with inflow occlusion Major vessel shunt Shunt; subclavian to pulmonary artery (Blalock-Taussig type operation) Major vessel shunt Shunt; ascending aorta to pulmonary artery (Waterston type operation) Shunt; descending aorta to pulmonary artery (Potts-Smith type Major vessel shunt operation) Major vessel shunt & graft Shunt; central, with prosthetic graft Shunt; superior vena cava to pulmonary artery for flow to one lung Major vessel shunt (classical Glenn procedure) Shunt; superior vena cava to pulmonary artery for flow to both lungs Major vessel shunt (bidirectional Glenn procedure) Anastomosis, cavopulmonary, second superior vena cava (List Cavopulmonary shunting separately in addition to primary procedure) Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; without surgical enlargement of ventricular Repair great vessels defect septal defect Repair of transposition of the great arteries with ventricular septal defect and subpulmonary stenosis; with surgical enlargement of ventricular Repair great vessels defect septal defect Repair of transposition of the great arteries, atrial baffle procedure (eg, Repair great vessels defect Mustard or Senning type) with cardiopulmonary bypass; Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with removal of Repair great vessels defect pulmonary band Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with closure of Repair great vessels defect ventricular septal defect Repair of transposition of the great arteries, atrial baffle procedure (eg, Mustard or Senning type) with cardiopulmonary bypass; with repair of Repair great vessels defect subpulmonic obstruction

9 Page 9 of 30 Repair of transposition of the great arteries, aortic pulmonary artery Repair great vessels defect reconstruction (eg, Jatene type); Repair of transposition of the great arteries, aortic pulmonary artery Repair great vessels defect reconstruction (eg, Jatene type); with removal of pulmonary band Repair of transposition of the great arteries, aortic pulmonary artery Repair great vessels defect reconstruction (eg, Jatene type); with closure of ventricular septal defect Repair of transposition of the great arteries, aortic pulmonary artery Repair great vessels defect reconstruction (eg, Jatene type); with repair of subpulmonic obstruction Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); without coronary ostium Nikaidoh proc reimplantation Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both Nikaidoh proc w/ostia implt coronary ostia Repair arterial trunk Total repair, truncus arteriosus (Rastelli type operation) Revision of pulmonary artery Reimplantation of an anomalous pulmonary artery Aortic suspension (aortopexy) for tracheal decompression (eg, for Aortic suspension tracheomalacia) (separate procedure) Repair vessel defect Division of aberrant vessel (vascular ring); Repair vessel defect Division of aberrant vessel (vascular ring); with reanastomosis Obliteration of aortopulmonary septal defect; without cardiopulmonary Repair septal defect bypass Obliteration of aortopulmonary septal defect; with cardiopulmonary Repair septal defect bypass Revise major vessel Repair of patent ductus arteriosus; by ligation Revise major vessel Repair of patent ductus arteriosus; by division, younger than 18 years Revise major vessel Repair of patent ductus arteriosus; by division, 18 years and older Excision of coarctation of aorta, with or without associated patent ductus Remove aorta constriction arteriosus; with direct anastomosis Excision of coarctation of aorta, with or without associated patent ductus Remove aorta constriction arteriosus; with graft Excision of coarctation of aorta, with or without associated patent ductus arteriosus; repair using either left subclavian artery or prosthetic material Remove aorta constriction as gusset for enlargement Repair of hypoplastic or interrupted aortic arch using autogenous or Repair septal defect prosthetic material; without cardiopulmonary bypass Repair of hypoplastic or interrupted aortic arch using autogenous or Repair septal defect prosthetic material; with cardiopulmonary bypass Ascending aorta graft, with cardiopulmonary bypass, with or without Ascending aortic graft valve suspension;

10 Page 10 of 30 Ascending aorta graft, with cardiopulmonary bypass, with or without valve suspension; with aortic root replacement using composite Ascending aortic graft prosthesis and coronary reconstruction Ascending aorta graft, with cardiopulmonary bypass with valve suspension, with coronary reconstruction and valve-sparing aortic root Ascending aortic graft remodeling (eg, david procedure, yacoub procedure) Transverse aortic arch graft Transverse arch graft, with cardiopulmonary bypass Thoracic aortic graft Descending thoracic aorta graft, with or without bypass Repair of thoracoabdominal aortic aneurysm with graft, with or without Thoracoabdominal graft cardiopulmonary bypass Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, Endovasc taa repr incl subcl initial endoprosthesis plus descending thora Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not involving coverage of left subclavian artery Endovasc taa repr w/o subcl origin, initial endoprosthesis plus descending t Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); initial Insert endovasc prosth taa extension Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each Endovasc prosth taa add-on additional proximal extension (List separatel Placement of distal extension prosthesis(s) delayed after endovascular Endovasc prosth delayed repair of descending thoracic aorta Open subclavian to carotid artery transposition performed in conjunction with endovascular repair of descending thoracic aorta, by neck incision, Artery transpose/endovas taa unilateral Bypass graft, with other than vein, transcervical retropharyngeal carotidcarotid, performed in conjunction with endovascular repair of descending Car-car bp grft/endovas taa thoracic aorta, by neck incision Remove lung artery emboli Pulmonary artery embolectomy; with cardiopulmonary bypass Remove lung artery emboli Pulmonary artery embolectomy; without cardiopulmonary bypass Pulmonary endarterectomy, with or without embolectomy, with Surgery of great vessel cardiopulmonary bypass Repair pulmonary artery Repair of pulmonary artery stenosis by reconstruction with patch or graft

11 Page 11 of 30 Repair of pulmonary atresia with ventricular septal defect, by construction or replacement of conduit from right or left ventricle to Repair pulmonary atresia pulmonary artery Transect pulmonary artery Transection of pulmonary artery with cardiopulmonary bypass Ligation and takedown of a systemic-to-pulmonary artery shunt, performed in conjunction with a congenital heart procedure (List Remove pulmonary shunt separately in addition to code for primary procedure) Repair of pulmonary artery arborization anomalies by unifocalization; Rpr pul art unifocal w/o cpb without cardiopulmonary bypass Repair of pulmonary artery arborization anomalies by unifocalization; Repr pul art unifocal w/cpb with cardiopulmonary bypass Implantation of a total replacement heart system (artificial heart) with Implantation of artificial heart recipient cardiectomy Removal and replacement of total replacement heart system Removal and replacement of total replacement heart system Removal of a total replacement heart system (artificial heart) for heart Removal of artificial heart transplantation (List separately in addition to code for primary procedure) Removal of donor heart/lung Donor cardiectomy-pneumonectomy (including cold preservation) Backbench standard preparation of cadaver donor heart/lung allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, and Prepare donor heart/lung trachea for implantation Transplantation heart/lung Heart-lung transplant with recipient cardiectomy-pneumonectomy Removal of donor heart Donor cardiectomy (including cold preservation) Backbench standard preparation of cadaver donor heart allograft prior to transplantation, including dissection of allograft from surrounding soft tissues to prepare aorta, superior vena cava, inferior vena cava, Prepare donor heart pulmonary artery, and left atrium for impla Transplantation of heart Heart transplant, with or without recipient cardiectomy Extracorporeal membrane oxygenation (ECMO)/extracorporeal life Ecmo/ecls initiation venous support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life Ecmo/ecls initiation artery support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, Ecmo/ecls daily mgmt-venous veno-venous Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; daily management, each day, Ecmo/ecls daily mgmt artery veno-arteria

12 Page 12 of 30 Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age Ecmo/ecls insj prph cannula (includes fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes Ecmo/ecls insj prph cannula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial Ecmo/ecls insj prph cannula and/or venous) cannula(e), open, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of peripheral (arterial Ecmo/ecls insj prph cannula and/or venous) cannula(e), open, 6 years and older Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by Ecmo/ecls insj ctr cannula sternotomy or thoracotomy, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; insertion of central cannula(e) by Ecmo/ecls insj ctr cannula sternotomy or thoracotomy, 6 years and older Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, birth through 5 years of age Ecmo/ecls repos perph cnula (includes fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), percutaneous, 6 years and older (includes Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, birth through 5 years of age (includes Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition peripheral (arterial and/or venous) cannula(e), open, 6 years and older (includes Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition of central cannula(e) by sternotomy or thoracotomy, birth through 5 years of age (includes Ecmo/ecls repos perph cnula fluoroscopic guidance, when performed)

13 Page 13 of 30 Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; reposition central cannula(e) by sternotomy or thoracotomy, 6 years and older (includes fluoroscopic Ecmo/ecls repos perph cnula guidance, when performed) Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial Ecmo/ecls rmvl perph cannula and/or venous) cannula(e), percutaneous, birth through 5 years of age Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial Ecmo/ecls rmvl prph cannula and/or venous) cannula(e), percutaneous, 6 years and older Insert ia percut device Insertion of intra-aortic balloon assist device, percutaneous Remove aortic assist device Removal of intra-aortic balloon assist device, percutaneous Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; removal of peripheral (arterial Ecmo/ecls rmvl perph cannula and/or venous) cannula(e), open, birth through 5 years of age Insertion of intra-aortic balloon assist device through the femoral artery, Aortic circulation assist open approach Removal of intra-aortic balloon assist device including repair of femoral Aortic circulation assist artery, with or without graft Insert balloon device Insertion of intra-aortic balloon assist device through the ascending aorta Removal of intra-aortic balloon assist device from the ascending aorta, Remove intra-aortic balloon including repair of the ascending aorta, with or without graft Implant ventricular device Insertion of ventricular assist device; extracorporeal, single ventricle Implant ventricular device Insertion of ventricular assist device; extracorporeal, biventricular Remove ventricular device Removal of ventricular assist device; extracorporeal, single ventricle Remove ventricular device Removal of ventricular assist device; extracorporeal, biventricular Insertion of ventricular assist device, implantable intracorporeal, single Insert intracorporeal device ventricle Removal of ventricular assist device, implantable intracorporeal, single Remove intracorporeal device ventricle Replacement of extracorporeal ventricular assist device, single or Replace vad pump ext biventricular, pump(s), single or each pump Replacement of ventricular assist device pump(s); implantable Replace vad intra w/o bp intracorporeal, single ventricle, without cardiopulmonary bypass Replacement of ventricular assist device pump(s); implantable Replace vad intra w/bp intracorporeal, single ventricle, with cardiopulmonary bypass Extracorporeal membrane oxygenation (ECMO)/extracorporeal life support (ECLS) provided by physician; Ecmo/ecls rmvl prph cannula

14 Page 14 of 30 Extracorporeal membrane oxygenation (ECMO)/extracorporeal life Ecmo/ecls rmvl ctr cannula support (ECLS) provided by physician; Extracorporeal membrane oxygenation (ECMO)/extracorporeal life Ecmo/ecls rmvl ctr cannula support (ECLS) provided by physician; Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support Artery expos/graft artery Services Insertion of left heart vent (ecmo) Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support Services Removal of left heart vent (ecmo) Extracorporeal Membrane Oxygenation Or Extracorporeal Life Support Services Insertion of ventricular assist device, percutaneous including radiological Insert vad artery access supervision and interpretation; arterial access only Insertion of ventricular assist device, percutaneous including radiological supervision and interpretation; both arterial and venous access, with Insert vad art&vein access transseptal puncture Removal of percutaneous ventricular assist device at separate and Remove vad different session distinct session from insertion Repositioning of percutaneous ventricular assist device with imaging Reposition vad diff session guidance at separate and distinct session from insertion Embolectomy or thrombectomy, with or without catheter; carotid, Removal of artery clot subclavian or innominate artery, by neck incision Embolectomy or thrombectomy, with or without catheter; innominate, Removal of artery clot subclavian artery, by thoracic incision Embolectomy or thrombectomy, with or without catheter; renal, celiac, Removal of artery clot mesentery, aortoiliac artery, by abdominal incision Thrombectomy, direct or with catheter; vena cava, iliac vein, by Removal of vein clot abdominal incision Thrombectomy, direct or with catheter; vena cava, iliac, femoropopliteal Removal of vein clot vein, by abdominal and leg incision Reconstruct vena cava Reconstruction of vena cava, any method Embolectomy or thrombectomy, with or without catheter; axillary, Evasc rpr a-ao ndgft brachial, innominate, subclavian artery, by arm incision Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, Evasc rpr a-ao ndgft rpt dissection, penetrating ulcer, traumatic disruption)

15 Page 15 of 30 Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for Evasc rpr a-unilac ndgft aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Evasc rpr a-unilac ndgft rpt Evac rpr a-biiliac ndgft Evasc rpr a-biiliac rpt Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer) Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-bi-iliac endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)

16 Page 16 of 30 Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous Evasc rpr ilio-iliac ndgft malformation) Endovascular repair of iliac artery by deployment of an ilio-iliac tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally to the iliac bifurcation, and treatment zone angioplasty/stenting, when performed, unilateral; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, Evasc rpr ilio-iliac rpt traumatic disruption) Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code Plmt xtn prosth evasc rpr for primary procedure) Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; Dlyd plmt xtn prosth 1st vsl initial vessel treated Delayed placement of distal or proximal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, endoleak, or endograft migration, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed; each additional vessel treated (List separately in addition to code for Dlyd plmt xtn prosth ea addl primary procedure)

17 Page 17 of 30 Transcatheter delivery of enhanced fixation device(s) to the endograft (eg, anchor, screw, tack) and all associated radiological supervision and Tcat dlvr enhncd fixj dev interpretation Endovascular repair of infrarenal abdominal aortic aneurysm or Endovas aaa repr w/sm tube dissection; using aorto-aortic tube prosthesis Endovascular repair of infrarenal abdominal aortic aneurysm or Endovas aaa repr w/2-p part dissection; using modular bifurcated prosthesis (one docking limb) Endovascular repair of infrarenal abdominal aortic aneurysm or Endovas aaa repr w/3-p part dissection; using modular bifurcated prosthesis (two docking limbs) Endovascular repair of infrarenal abdominal aortic aneurysm or Endovas aaa repr w/1-p part dissection; using unibody bifurcated prosthesis Endovascular repair of infrarenal abdominal aortic aneurysm or Endovas aaa repr w/long tube dissection; using aorto-uniiliac or aorto-unifemoral prosthesis Transcatheter placement of wireless physiologic sensor in aneurysmal sac during endovascular repair, including radiological supervision and Aneurysm press sensor addon interpretation, instrument calibration, and collection of pressure data (list separately in addition to code for primary procedure) Endovascular placement of iliac artery occlusion device (List separately Endovas iliac a device addon in addition to code for primary procedure) Open femoral artery exposure for delivery of endovascular prosthesis, Xpose for endoprosth femorl by groin incision, unilateral Placement of femoral-femoral prosthetic graft during endovascular aortic aneurysm repair (List separately in addition to code for primary Femoral endovas graft add-on procedure) Open iliac artery exposure for delivery of endovascular prosthesis or iliac occlusion during endovascular therapy, by abdominal or retroperitoneal Xpose for endoprosth iliac incision, unilateral Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, Endovasc extend prosth init or dissection; initial vessel Placement of proximal or distal extension prosthesis for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, or dissection; each additional vessel (List separately in addition to code Endovasc exten prosth addl for primary procedure) Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; Open aortic tube prosth repr tube prosthesis Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; Open aortoiliac prosth repr aorto-bi-iliac prosthesis

18 Page 18 of 30 Open repair of infrarenal aortic aneurysm or dissection, plus repair of associated arterial trauma, following unsuccessful endovascular repair; Open aortofemor prosth repr aorto-bifemoral prosthesis Open iliac artery exposure with creation of conduit for delivery of aortic or iliac endovascular prosthesis, by abdominal or retroperitoneal incision, Xpose for endoprosth iliac unilateral Open brachial artery exposure to assist in the deployment of aortic or Xpose endoprosth brachial iliac endovascular prosthesis by arm incision, unilateral Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery Endovasc visc aorta 1 graft endoprosthesis (superior mesenteric, celiac or renal artery) Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery Endovasc visc aorta 2 graft endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Endovasc visc aorta 3 graft Endovasc visc aorta 4 graft Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])

19 Page 19 of 30 Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal Visc & infraren abd 1 prosth artery) Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal Visc & infraren abd 2 prosth artery[s]) Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s]) Visc & infraren abd 3 prosth Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including four or more visceral artery endoprostheses (superior mesenteric, celiac and/or Visc & infraren abd 4+ prost renal artery[s]) Endovascular graft placement for repair of iliac artery (eg, aneurysm, Endovasc iliac repr w/graft pseudoaneurysm, arteriovenous malformation, trauma) Repair defect of artery Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm and associated occlusive disease, carotid, subclavian artery, by neck incision