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The CPT® Code 69990 refers to the use of microsurgical techniques that necessitate the utilization of an operating microscope. This code is specifically designated to be reported separately in addition to the code for the primary procedure being performed. Microsurgery is a specialized surgical technique that is often employed for intricate procedures such as the anastomosis of small blood vessels and nerves, as well as for various forms of tissue reconstruction. During these procedures, the surgeon relies on the operating microscope to gain a magnified view of the surgical field, which is crucial for the precise manipulation of delicate structures. The operating microscope enhances the surgeon's ability to visualize blood vessels, nerves, individual nerve fibers, and other tissues, thereby facilitating meticulous dissection and mobilization. The surgeon operates the microscope using a foot pedal, allowing for dynamic adjustments in focus and positioning throughout the surgery. This level of precision is essential for controlling bleeding and ensuring the accurate repair of the targeted structures, as the operating microscope enables the exact approximation of blood vessels, nerves, and tissue planes, which is vital for successful surgical outcomes.
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The microsurgical techniques described by CPT® Code 69990 are indicated for a variety of surgical scenarios where precision is paramount. These indications include:
The procedure utilizing CPT® Code 69990 involves several critical steps that ensure the successful execution of microsurgical techniques. These steps include:
Post-procedure care following the use of CPT® Code 69990 involves monitoring the patient for any complications related to the microsurgical techniques performed. This includes assessing the surgical site for signs of infection, ensuring proper blood flow to the repaired vessels or nerves, and monitoring for any neurological deficits if nerves were involved. Patients may require follow-up appointments to evaluate the healing process and the functionality of the repaired structures. Pain management and rehabilitation may also be necessary, depending on the extent of the surgery and the specific tissues involved.
| Short Descr | MICROSURGERY ADD-ON | Medium Descr | MICROSURG TQS REQ USE OPERATING MICROSCOPE | Long Descr | Microsurgical techniques, requiring use of operating microscope (List separately in addition to code for primary procedure) | Status Code | Restricted Coverage | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | Y1 - Other - Medicare fee schedule | MUE | 1 | CCS Clinical Classification | 231 - Other therapeutic procedures |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 61304 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniectomy or craniotomy, exploratory; supratentorial | 61305 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy, exploratory; infratentorial (posterior fossa) | 61312 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy or craniotomy for evacuation of hematoma, supratentorial; extradural or subdural | 61313 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy or craniotomy for evacuation of hematoma, supratentorial; intracerebral | 61314 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy for evacuation of hematoma, infratentorial; extradural or subdural | 61315 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy or craniotomy for evacuation of hematoma, infratentorial; intracerebellar | 61316 | Addon Code MPFS Status: Active Code APC C 1Incision and subcutaneous placement of cranial bone graft (List separately in addition to code for primary procedure) | 61320 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy, drainage of intracranial abscess; supratentorial | 61321 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniectomy or craniotomy, drainage of intracranial abscess; infratentorial | 61322 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; without lobectomy | 61323 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy, decompressive, with or without duraplasty, for treatment of intracranial hypertension, without evacuation of associated intraparenchymal hematoma; with lobectomy | 61330 | MPFS Status: Active Code APC J1 ASC G2 1Decompression of orbit only, transcranial approach | 61333 | MPFS Status: Active Code APC C 1Exploration of orbit (transcranial approach), with removal of lesion | 61340 | MPFS Status: Active Code APC C 1Subtemporal cranial decompression (pseudotumor cerebri, slit ventricle syndrome) | 61343 | MPFS Status: Active Code APC C 1Craniectomy, suboccipital with cervical laminectomy for decompression of medulla and spinal cord, with or without dural graft (eg, Arnold-Chiari malformation) | 61345 | MPFS Status: Active Code APC C 1Other cranial decompression, posterior fossa | 61450 | MPFS Status: Active Code APC C 1Craniectomy, subtemporal, for section, compression, or decompression of sensory root of gasserian ganglion | 61458 | MPFS Status: Active Code APC C 1Craniectomy, suboccipital; for exploration or decompression of cranial nerves | 61460 | MPFS Status: Active Code APC C 1Craniectomy, suboccipital; for section of 1 or more cranial nerves | 61500 | MPFS Status: Active Code APC C 1Craniectomy; with excision of tumor or other bone lesion of skull | 61501 | MPFS Status: Active Code APC C 1Craniectomy; for osteomyelitis | 61510 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy, trephination, bone flap craniotomy; for excision of brain tumor, supratentorial, except meningioma | 61512 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy, trephination, bone flap craniotomy; for excision of meningioma, supratentorial | 61514 | MPFS Status: Active Code APC C 1Craniectomy, trephination, bone flap craniotomy; for excision of brain abscess, supratentorial | 61516 | MPFS Status: Active Code APC C 1Craniectomy, trephination, bone flap craniotomy; for excision or fenestration of cyst, supratentorial | 61517 | Addon Code MPFS Status: Active Code APC C 1Implantation of brain intracavitary chemotherapy agent (List separately in addition to code for primary procedure) | 61518 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy for excision of brain tumor, infratentorial or posterior fossa; except meningioma, cerebellopontine angle tumor, or midline tumor at base of skull | 61519 | MPFS Status: Active Code APC C 1Craniectomy for excision of brain tumor, infratentorial or posterior fossa; meningioma | 61520 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy for excision of brain tumor, infratentorial or posterior fossa; cerebellopontine angle tumor | 61521 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniectomy for excision of brain tumor, infratentorial or posterior fossa; midline tumor at base of skull | 61522 | MPFS Status: Active Code APC C 1Craniectomy, infratentorial or posterior fossa; for excision of brain abscess | 61524 | MPFS Status: Active Code APC C 1Craniectomy, infratentorial or posterior fossa; for excision or fenestration of cyst | 61526 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; | 61530 | MPFS Status: Active Code APC C Physician Quality Reporting 1Craniectomy, bone flap craniotomy, transtemporal (mastoid) for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy | 61531 | MPFS Status: Active Code APC C CPT Assistant Article 1Subdural implantation of strip electrodes through 1 or more burr or trephine hole(s) for long-term seizure monitoring | 61533 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniotomy with elevation of bone flap; for subdural implantation of an electrode array, for long-term seizure monitoring | 61534 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for excision of epileptogenic focus without electrocorticography during surgery | 61535 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniotomy with elevation of bone flap; for removal of epidural or subdural electrode array, without excision of cerebral tissue (separate procedure) | 61536 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for excision of cerebral epileptogenic focus, with electrocorticography during surgery (includes removal of electrode array) | 61537 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, without electrocorticography during surgery | 61538 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for lobectomy, temporal lobe, with electrocorticography during surgery | 61539 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, with electrocorticography during surgery | 61540 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for lobectomy, other than temporal lobe, partial or total, without electrocorticography during surgery | 61541 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for transection of corpus callosum | 61543 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for partial or subtotal (functional) hemispherectomy | 61544 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for excision or coagulation of choroid plexus | 61545 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for excision of craniopharyngioma | 61546 | MPFS Status: Active Code APC C 1Craniotomy for hypophysectomy or excision of pituitary tumor, intracranial approach | 61550 | MPFS Status: Active Code APC C 1Craniectomy for craniosynostosis; single cranial suture | 61552 | MPFS Status: Active Code APC C 1Craniectomy for craniosynostosis; multiple cranial sutures | 61556 | MPFS Status: Active Code APC C 1Craniotomy for craniosynostosis; frontal or parietal bone flap | 61557 | MPFS Status: Active Code APC C 1Craniotomy for craniosynostosis; bifrontal bone flap | 61558 | MPFS Status: Active Code APC C 1Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); not requiring bone grafts | 61559 | MPFS Status: Active Code APC C 1Extensive craniectomy for multiple cranial suture craniosynostosis (eg, cloverleaf skull); recontouring with multiple osteotomies and bone autografts (eg, barrel-stave procedure) (includes obtaining grafts) | 61563 | MPFS Status: Active Code APC C 1Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); without optic nerve decompression | 61564 | MPFS Status: Active Code APC C 1Excision, intra and extracranial, benign tumor of cranial bone (eg, fibrous dysplasia); with optic nerve decompression | 61566 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for selective amygdalohippocampectomy | 61567 | MPFS Status: Active Code APC C 1Craniotomy with elevation of bone flap; for multiple subpial transections, with electrocorticography during surgery | 61570 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy; with excision of foreign body from brain | 61571 | MPFS Status: Active Code APC C 1Craniectomy or craniotomy; with treatment of penetrating wound of brain | 61575 | MPFS Status: Active Code APC C 1Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; | 61576 | MPFS Status: Active Code APC C CPT Assistant Article 1Transoral approach to skull base, brain stem or upper spinal cord for biopsy, decompression or excision of lesion; requiring splitting of tongue and/or mandible (including tracheostomy) | 61580 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, ethmoidectomy, sphenoidectomy, without maxillectomy or orbital exenteration | 61581 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Craniofacial approach to anterior cranial fossa; extradural, including lateral rhinotomy, orbital exenteration, ethmoidectomy, sphenoidectomy and/or maxillectomy | 61582 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniofacial approach to anterior cranial fossa; extradural, including unilateral or bifrontal craniotomy, elevation of frontal lobe(s), osteotomy of base of anterior cranial fossa | 61583 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniofacial approach to anterior cranial fossa; intradural, including unilateral or bifrontal craniotomy, elevation or resection of frontal lobe, osteotomy of base of anterior cranial fossa | 61584 | MPFS Status: Active Code APC C CPT Assistant Article 1Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); without orbital exenteration | 61585 | MPFS Status: Active Code APC C CPT Assistant Article 1Orbitocranial approach to anterior cranial fossa, extradural, including supraorbital ridge osteotomy and elevation of frontal and/or temporal lobe(s); with orbital exenteration | 61586 | MPFS Status: Active Code APC C CPT Assistant Article 1Bicoronal, transzygomatic and/or LeFort I osteotomy approach to anterior cranial fossa with or without internal fixation, without bone graft | 61590 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Infratemporal pre-auricular approach to middle cranial fossa (parapharyngeal space, infratemporal and midline skull base, nasopharynx), with or without disarticulation of the mandible, including parotidectomy, craniotomy, decompression and/or mobilization of the facial nerve and/or petrous carotid artery | 61591 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Infratemporal post-auricular approach to middle cranial fossa (internal auditory meatus, petrous apex, tentorium, cavernous sinus, parasellar area, infratemporal fossa) including mastoidectomy, resection of sigmoid sinus, with or without decompression and/or mobilization of contents of auditory canal or petrous carotid artery | 61592 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Orbitocranial zygomatic approach to middle cranial fossa (cavernous sinus and carotid artery, clivus, basilar artery or petrous apex) including osteotomy of zygoma, craniotomy, extra- or intradural elevation of temporal lobe | 61595 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code 1Transtemporal approach to posterior cranial fossa, jugular foramen or midline skull base, including mastoidectomy, decompression of sigmoid sinus and/or facial nerve, with or without mobilization | 61596 | MPFS Status: Active Code APC C Physician Quality Reporting Illustration for Code 1Transcochlear approach to posterior cranial fossa, jugular foramen or midline skull base, including labyrinthectomy, decompression, with or without mobilization of facial nerve and/or petrous carotid artery | 61597 | MPFS Status: Active Code APC C CPT Assistant Article 1Transcondylar (far lateral) approach to posterior cranial fossa, jugular foramen or midline skull base, including occipital condylectomy, mastoidectomy, resection of C1-C3 vertebral body(s), decompression of vertebral artery, with or without mobilization | 61598 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Transpetrosal approach to posterior cranial fossa, clivus or foramen magnum, including ligation of superior petrosal sinus and/or sigmoid sinus | 61600 | MPFS Status: Active Code APC C CPT Assistant Article 1Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; extradural | 61601 | MPFS Status: Active Code APC C CPT Assistant Article 1Resection or excision of neoplastic, vascular or infectious lesion of base of anterior cranial fossa; intradural, including dural repair, with or without graft | 61605 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; extradural | 61606 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code 1Resection or excision of neoplastic, vascular or infectious lesion of infratemporal fossa, parapharyngeal space, petrous apex; intradural, including dural repair, with or without graft | 61607 | MPFS Status: Active Code APC C CPT Assistant Article 1Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; extradural | 61608 | MPFS Status: Active Code APC C CPT Assistant Article 1Resection or excision of neoplastic, vascular or infectious lesion of parasellar area, cavernous sinus, clivus or midline skull base; intradural, including dural repair, with or without graft | 61611 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Transection or ligation, carotid artery in petrous canal; without repair (List separately in addition to code for primary procedure) | 61613 | MPFS Status: Active Code APC C CPT Assistant Article 1Obliteration of carotid aneurysm, arteriovenous malformation, or carotid-cavernous fistula by dissection within cavernous sinus | 61615 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; extradural | 61616 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article Illustration for Code 1Resection or excision of neoplastic, vascular or infectious lesion of base of posterior cranial fossa, jugular foramen, foramen magnum, or C1-C3 vertebral bodies; intradural, including dural repair, with or without graft | 61618 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by free tissue graft (eg, pericranium, fascia, tensor fascia lata, adipose tissue, homologous or synthetic grafts) | 61619 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Secondary repair of dura for cerebrospinal fluid leak, anterior, middle or posterior cranial fossa following surgery of the skull base; by local or regionalized vascularized pedicle flap or myocutaneous flap (including galea, temporalis, frontalis or occipitalis muscle) | 61623 | MPFS Status: Active Code APC J1 Physician Quality Reporting CPT Assistant Article Illustration for Code 1Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiography required for balloon occlusion and to exclude vascular injury post occlusion | 61624 | MPFS Status: Active Code APC C CPT Assistant Article Illustration for Code 1Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; central nervous system (intracranial, spinal cord) | 61626 | MPFS Status: Active Code APC J1 CPT Assistant Article Illustration for Code 1Transcatheter permanent occlusion or embolization (eg, for tumor destruction, to achieve hemostasis, to occlude a vascular malformation), percutaneous, any method; non-central nervous system, head or neck (extracranial, brachiocephalic branch) | 61630 | MPFS Status: Restricted APC C CPT Assistant Article 1Balloon angioplasty, intracranial (eg, atherosclerotic stenosis), percutaneous | 61635 | MPFS Status: Restricted APC C CPT Assistant Article 1Transcatheter placement of intravascular stent(s), intracranial (eg, atherosclerotic stenosis), including balloon angioplasty, if performed | 61640 | MPFS Status: Non-covered Service APC E1 CPT Assistant Article 1Balloon dilatation of intracranial vasospasm, percutaneous; initial vessel | 61641 | Addon Code MPFS Status: Non-covered Service APC E1 CPT Assistant Article 1Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in same vascular territory (List separately in addition to code for primary procedure) | 61642 | Addon Code MPFS Status: Non-covered Service APC E1 CPT Assistant Article 1Balloon dilatation of intracranial vasospasm, percutaneous; each additional vessel in different vascular territory (List separately in addition to code for primary procedure) | 61645 | MPFS Status: Active Code APC C 1Percutaneous arterial transluminal mechanical thrombectomy and/or infusion for thrombolysis, intracranial, any method, including diagnostic angiography, fluoroscopic guidance, catheter placement, and intraprocedural pharmacological thrombolytic injection(s) | 61650 | MPFS Status: Active Code APC C 1Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; initial vascular territory | 61651 | Add-on Code MPFS Status: Active Code APC C 1Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List separately in addition to code for primary procedure) | 61680 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; supratentorial, simple | 61682 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; supratentorial, complex | 61684 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; infratentorial, simple | 61686 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; infratentorial, complex | 61690 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; dural, simple | 61692 | MPFS Status: Active Code APC C 1Surgery of intracranial arteriovenous malformation; dural, complex | 61697 | MPFS Status: Active Code APC C Physician Quality Reporting 1Surgery of complex intracranial aneurysm, intracranial approach; carotid circulation | 61698 | MPFS Status: Active Code APC C 1Surgery of complex intracranial aneurysm, intracranial approach; vertebrobasilar circulation | 61700 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Surgery of simple intracranial aneurysm, intracranial approach; carotid circulation | 61702 | MPFS Status: Active Code APC C 1Surgery of simple intracranial aneurysm, intracranial approach; vertebrobasilar circulation | 61703 | MPFS Status: Active Code APC C 1Surgery of intracranial aneurysm, cervical approach by application of occluding clamp to cervical carotid artery (Selverstone-Crutchfield type) | 61705 | MPFS Status: Active Code APC C 1Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial and cervical occlusion of carotid artery | 61708 | MPFS Status: Active Code APC C CPT Assistant Article 1Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intracranial electrothrombosis | 61710 | MPFS Status: Active Code APC C CPT Assistant Article 1Surgery of aneurysm, vascular malformation or carotid-cavernous fistula; by intra-arterial embolization, injection procedure, or balloon catheter | 61711 | MPFS Status: Active Code APC C 1Anastomosis, arterial, extracranial-intracranial (eg, middle cerebral/cortical) arteries | 62010 | MPFS Status: Active Code APC C 1Elevation of depressed skull fracture; with repair of dura and/or debridement of brain | 62100 | MPFS Status: Active Code APC C CPT Assistant Article 1Craniotomy for repair of dural/cerebrospinal fluid leak, including surgery for rhinorrhea/otorrhea | 63081 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, single segment | 63082 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, anterior approach with decompression of spinal cord and/or nerve root(s); cervical, each additional segment (List separately in addition to code for primary procedure) | 63085 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, single segment | 63086 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, transthoracic approach with decompression of spinal cord and/or nerve root(s); thoracic, each additional segment (List separately in addition to code for primary procedure) | 63087 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; single segment | 63088 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, combined thoracolumbar approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic or lumbar; each additional segment (List separately in addition to code for primary procedure) | 63090 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; single segment | 63091 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, transperitoneal or retroperitoneal approach with decompression of spinal cord, cauda equina or nerve root(s), lower thoracic, lumbar, or sacral; each additional segment (List separately in addition to code for primary procedure) | 63101 | MPFS Status: Active Code APC C Physician Quality Reporting 1Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic, single segment | 63102 | MPFS Status: Active Code APC C Physician Quality Reporting CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); lumbar, single segment | 63103 | Addon Code MPFS Status: Active Code APC C Physician Quality Reporting 1Vertebral corpectomy (vertebral body resection), partial or complete, lateral extracavitary approach with decompression of spinal cord and/or nerve root(s) (eg, for tumor or retropulsed bone fragments); thoracic or lumbar, each additional segment (List separately in addition to code for primary procedure) | 63170 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with myelotomy (eg, Bischof or DREZ type), cervical, thoracic, or thoracolumbar | 63172 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with drainage of intramedullary cyst/syrinx; to subarachnoid space | 63173 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with drainage of intramedullary cyst/syrinx; to peritoneal or pleural space | 63185 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with rhizotomy; 1 or 2 segments | 63190 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with rhizotomy; more than 2 segments | 63191 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with section of spinal accessory nerve | 63197 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy with cordotomy, with section of both spinothalamic tracts, 1 stage, thoracic | 63200 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy, with release of tethered spinal cord, lumbar | 63250 | MPFS Status: Active Code APC C 1Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; cervical | 63251 | MPFS Status: Active Code APC C 1Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracic | 63252 | MPFS Status: Active Code APC C 1Laminectomy for excision or occlusion of arteriovenous malformation of spinal cord; thoracolumbar | 63265 | MPFS Status: Active Code APC J1 1Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; cervical | 63266 | MPFS Status: Active Code APC J1 1Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; thoracic | 63267 | MPFS Status: Active Code APC J1 Physician Quality Reporting 1Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; lumbar | 63268 | MPFS Status: Active Code APC J1 1Laminectomy for excision or evacuation of intraspinal lesion other than neoplasm, extradural; sacral | 63270 | MPFS Status: Active Code APC C 1Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; cervical | 63271 | MPFS Status: Active Code APC C 1Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; thoracic | 63272 | MPFS Status: Active Code APC C 1Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; lumbar | 63273 | MPFS Status: Active Code APC C 1Laminectomy for excision of intraspinal lesion other than neoplasm, intradural; sacral | 63275 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, cervical | 63276 | MPFS Status: Active Code APC C Physician Quality Reporting 1Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, thoracic | 63277 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, lumbar | 63278 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; extradural, sacral | 63280 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, cervical | 63281 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, thoracic | 63282 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, extramedullary, lumbar | 63283 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, sacral | 63285 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, cervical | 63286 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracic | 63287 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; intradural, intramedullary, thoracolumbar | 63290 | MPFS Status: Active Code APC C 1Laminectomy for biopsy/excision of intraspinal neoplasm; combined extradural-intradural lesion, any level | 63295 | Addon Code MPFS Status: Active Code APC C 1Osteoplastic reconstruction of dorsal spinal elements, following primary intraspinal procedure (List separately in addition to code for primary procedure) | 63300 | MPFS Status: Active Code APC C CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, cervical | 63301 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by transthoracic approach | 63302 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, thoracic by thoracolumbar approach | 63303 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; extradural, lumbar or sacral by transperitoneal or retroperitoneal approach | 63304 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, cervical | 63305 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by transthoracic approach | 63306 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, thoracic by thoracolumbar approach | 63307 | MPFS Status: Active Code APC C 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; intradural, lumbar or sacral by transperitoneal or retroperitoneal approach | 63308 | Addon Code MPFS Status: Active Code APC C CPT Assistant Article 1Vertebral corpectomy (vertebral body resection), partial or complete, for excision of intraspinal lesion, single segment; each additional segment (List separately in addition to codes for single segment) | 63704 | Modifier 63 Exempt MPFS Status: Active Code APC C 1Repair of myelomeningocele; less than 5 cm diameter | 63706 | Modifier 63 Exempt MPFS Status: Active Code APC C 1Repair of myelomeningocele; larger than 5 cm diameter | 63707 | MPFS Status: Active Code APC C CPT Assistant Article 1Repair of dural/cerebrospinal fluid leak, not requiring laminectomy | 63709 | MPFS Status: Active Code APC C CPT Assistant Article 1Repair of dural/cerebrospinal fluid leak or pseudomeningocele, with laminectomy | 63710 | MPFS Status: Active Code APC C 1Dural graft, spinal | 64831 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article Illustration for Code 1Suture of digital nerve, hand or foot; 1 nerve | 64834 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Suture of 1 nerve; hand or foot, common sensory nerve | 64835 | MPFS Status: Active Code APC J1 ASC A2 1Suture of 1 nerve; median motor thenar | 64836 | MPFS Status: Active Code APC J1 ASC A2 1Suture of 1 nerve; ulnar motor | 64840 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Suture of posterior tibial nerve | 64856 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Suture of major peripheral nerve, arm or leg, except sciatic; including transposition | 64857 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Suture of major peripheral nerve, arm or leg, except sciatic; without transposition | 64858 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Suture of sciatic nerve | 64861 | MPFS Status: Active Code APC J1 ASC A2 1Suture of; brachial plexus | 64862 | MPFS Status: Active Code APC J1 ASC A2 1Suture of; lumbar plexus | 64864 | MPFS Status: Active Code APC J1 ASC A2 1Suture of facial nerve; extracranial | 64865 | MPFS Status: Active Code APC J1 ASC J8 1Suture of facial nerve; infratemporal, with or without grafting | 64866 | MPFS Status: Active Code APC C 1Anastomosis; facial-spinal accessory | 64868 | MPFS Status: Active Code APC C 1Anastomosis; facial-hypoglossal | 64885 | MPFS Status: Active Code APC J1 ASC A2 CPT Assistant Article 1Nerve graft (includes obtaining graft), head or neck; up to 4 cm in length | 64886 | MPFS Status: Active Code APC J1 ASC J8 CPT Assistant Article 1Nerve graft (includes obtaining graft), head or neck; more than 4 cm length | 64890 | MPFS Status: Active Code APC J1 ASC J8 Illustration for Code 1Nerve graft (includes obtaining graft), single strand, hand or foot; up to 4 cm length | 64891 | MPFS Status: Active Code APC J1 ASC J8 Illustration for Code 1Nerve graft (includes obtaining graft), single strand, hand or foot; more than 4 cm length | 64905 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Nerve pedicle transfer; first stage | 64907 | MPFS Status: Active Code APC J1 ASC A2 Illustration for Code 1Nerve pedicle transfer; second stage |
| 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | GC | This service has been performed in part by a resident under the direction of a teaching physician | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 26 | Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 57 | Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 77 | Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | CR | Catastrophe/disaster related | ET | Emergency services | F1 | Left hand, second digit | F3 | Left hand, fourth digit | F5 | Right hand, thumb | F8 | Right hand, fourth digit | F9 | Right hand, fifth digit | FA | Left hand, thumb | GJ | "opt out" physician or practitioner emergency or urgent service | GV | Attending physician not employed or paid under arrangement by the patient's hospice provider | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | RT | Right side (used to identify procedures performed on the right side of the body) | SA | Nurse practitioner rendering service in collaboration with a physician | SG | Ambulatory surgical center (asc) facility service | TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
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Date
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Action
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Notes
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| 2002-01-01 | Changed | Code description changed. |
| 1999-01-01 | Added | First appearance in code book in 1999. |