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, 200915>10>
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