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Attachment SSI-1


Breast Surgery (BRST) CPT Codes

Note: codes 11200 to 17250 are not specific to the breast, and should be reported only when referring to procedures done on the breast.


Note (January 2006): Based on revisions/updates to the ICD-9-CM codes, additional procedure codes were added to Breast Surgery (85.93-85.96). Please include in your reports those procedures with the CPT-4 code equivalents of the new reportable ICD-9-CM codes specified here until the equivalent CPT-4 codes are identified.

0061T Destroy breast cancer‑thermotx


11200 Removal of multiple skin tags, 1‑15


11201 Removal of skin tag‑ea additional 10

11400 Excise benign skin lesion <.6 CM

11401 Excise benign skin lesion .6‑1 CM

11402 Excise benign skin lesion 1‑2 CM

11403 Excise benign skin lesion 2‑3 CM

11404 Excise benign skin lesion 3‑4 CM

11406 Excise benign skin lesion >4 CM

11600 Excise malignant skin lesion <.6 CM

11601 Excise malignant skin lesion .6‑1 CM

11602 Excise malignant skin lesion 1‑2 CM

11603 Excise malignant skin lesion 2‑3 CM

11604 Excise malignant skin lesion 3‑4 CM

11606 Excise malignant skin lesion >4 CM

11970 Replace tissue expander with prosthesis

11971 Removal of tissue expander without insertion of prosthesis

17000 Destroy benign skin lesion‑1st

17003 Destroy benign lesion 2‑14 each

17004 Destroy benign lesion >14

17106 Destroy vascular lesion <10 sq cm

17107 Destroy vascular lesion 10‑50 sq cm

17108 Destroy vascular lesion >50 sq cm

17110 Destroy flat wart <15 lesions

17111 Destroy flat wart >14 lesions

17250 Chemical cauterization of granulation tissue

19101 Open incisional breast biopsy

19112 Lactiferous duct fistulectomy

19120 Open excision of breast lesion

19125 Open excision of breast lesion/marker‑1

19126 Open excision of breast lesion/marker‑additional

19140 Mastectomy for gynecomastia

19160 Partial mastectomy

19162 Partial mastectomy w axillary lymphadenectomy

19180 Simple complete mastectomy

19182 Subcutaneous mastectomy

19200 Radical mastectomy

19220 Urban type mastectomy

19240 Modified radical mastectomy

19316 Mastopexy

19318 Reduction mammoplasty

19324 Augmentation mammaplasty w/o implant

19325 Augmentation mammoplasty w implant

19328 Removal of intact mammary implant

19330 Removal of mammary implant material

19340 Immediate insertion of breast prosthesis

19342 Delayed insertion of breast prosthesis following mastoplexy, mastectomy, or in reconstruction

19357 Breast reconstruction, immediate or delayed, with tissue expander, including subsequent expansion

19361 Breast reconstruction with latissimus dorsi flap, without prosthetic implant

19364 Breast reconstruction w free flap

19366 Breast reconstruction nec

19367 Breast reconstruction/tram single pedicle

19368 Breast reconstruction/tram 1 pedicle microvascular

19369 Breast reconstruction/tram double pedicle

19371 Periprosthetic capsulectomy, breast
Hernia Surgery (HER) CPT Codes

49491 Repair initial reducible inguinal hernia, birth – under 50 weeks

49492 Repair initial incarcerated inguinal hernia, age 50 weeks – under 6 months

49495 Repair initial reducible inguinal hernia, age 50 weeks – under 6 months

49496 Repair incarcerated inguinal hernia, under 6 months age

49500 Repair reducible inguinal hernia age, 6 months – under 5 years

49501 Repair incarcerated inguinal hernia age, 6 months – under 5 years

49505 Repair reducible inguinal hernia, age 5 and over

49507 Repair incarcerated inguinal hernia, age 5 and over

49520 Repair recurrent reducible inguinal hernia

49521 Repair recurrent incarcerated or strangulated inguinal hernia

49525 Sliding inguinal hernia repair

49550 Repair initial reducible femoral hernia

49553 Repair incarcerated or strangulated femoral hernia

49555 Repair recurrent reducible femoral hernia

49557 Repair recurrent incarcerated femoral hernia

49560 Repair initial incisional or ventral hernia

49561 Repair initial incarcerated or strangulated hernia

49565 Repair recurrent reducible incisional or ventral hernia

49566 Repair recurrent incarcerated or strangulated hernia

49568 Mesh implantation‑incisional or ventral hernia

49570 Repair reducible epigastric hernia

49572 Repair incarcerated or strangulated epigastric hernia

49580 Repair reducible umbilical hernia, under 5 years of age

49582 Repair incarcerated umbilical hernia, under 5 years of age

49585 Repair reducible umbilical hernia, age 5 and over

49587 Repair incarcerated or strangulated umbilical hernia, age 5 and over

49590 Spigelian hernia repair

49600 Small omphalocele repair

49605 Large omphalocele repair

49606 Repair large omphalocele w removal of prosthesis

49610 Repair omphalocele‑1st stage

49611 Repair omphalocele‑2nd stage

49650 Laparoscopy, surgical repair, initial inguinal hernia

49651 Laparoscopy, repair recurrent inguinal hernia

49659 Unlisted laparoscopy procedure, hernia repair

54640 Orchioplexy‑inguinal approach, w or w/o hernia repair

55540 Excise varicocele + hernia repair



January 22, 2009

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