TABLE 6B - NEW PROCEDURE CODES
Procedure Code	Description	O.R.	MDC	MS-DRG
04LE0CV	Occlusion of Right Prostatic Artery with Extraluminal Device, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE0DV	Occlusion of Right Prostatic Artery with Intraluminal Device, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE0ZV	Occlusion of Right Prostatic Artery, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE3CV	Occlusion of Right Prostatic Artery with Extraluminal Device, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE3DV	Occlusion of Right Prostatic Artery with Intraluminal Device, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE3ZV	Occlusion of Right Prostatic Artery, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE4CV	Occlusion of Right Prostatic Artery with Extraluminal Device, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE4DV	Occlusion of Right Prostatic Artery with Intraluminal Device, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LE4ZV	Occlusion of Right Prostatic Artery, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF0CW	Occlusion of Left Prostatic Artery with Extraluminal Device, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF0DW	Occlusion of Left Prostatic Artery with Intraluminal Device, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF0ZW	Occlusion of Left Prostatic Artery, Open Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF3CW	Occlusion of Left Prostatic Artery with Extraluminal Device, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF3DW	Occlusion of Left Prostatic Artery with Intraluminal Device, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF3ZW	Occlusion of Left Prostatic Artery, Percutaneous Approach	Y	05	264
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF4CW	Occlusion of Left Prostatic Artery with Extraluminal Device, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF4DW	Occlusion of Left Prostatic Artery with Intraluminal Device, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
04LF4ZW	Occlusion of Left Prostatic Artery, Percutaneous Endoscopic Approach	Y	05	252, 253, 254
""			12	715, 716, 717, 718
""			21	907, 908, 909
""			24	957, 958, 959
""				987, 988, 989
0DX80ZB	Transfer Small Intestine to Bladder, Open Approach	Y	11	653, 654, 655
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX80ZC	Transfer Small Intestine to Right Ureter, Open Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX80ZD	Transfer Small Intestine to Left Ureter, Open Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX80ZF	Transfer Small Intestine to Bilateral Ureters, Open Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX84ZB	Transfer Small Intestine to Bladder, Percutaneous Endoscopic Approach	Y	11	653, 654, 655
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX84ZC	Transfer Small Intestine to Right Ureter, Percutaneous Endoscopic Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX84ZD	Transfer Small Intestine to Left Ureter, Percutaneous Endoscopic Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DX84ZF	Transfer Small Intestine to Bilateral Ureters, Percutaneous Endoscopic Approach	Y	11	656, 657, 658, 659, 660, 661
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DXE0ZB	Transfer Large Intestine to Bladder, Open Approach	Y	11	653, 654, 655
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0DXE4ZB	Transfer Large Intestine to Bladder, Percutaneous Endoscopic Approach	Y	11	653, 654, 655
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
0NP003Z	Removal of Infusion Device from Skull, Open Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NP033Z	Removal of Infusion Device from Skull, Percutaneous Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NP043Z	Removal of Infusion Device from Skull, Percutaneous Endoscopic Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NP0X3Z	Removal of Infusion Device from Skull, External Approach	N		
0NW003Z	Revision of Infusion Device in Skull, Open Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NW033Z	Revision of Infusion Device in Skull, Percutaneous Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NW043Z	Revision of Infusion Device in Skull, Percutaneous Endoscopic Approach	Y	01	023, 024, 025, 026, 027
""				987, 988, 989
0NW0X3Z	Revision of Infusion Device in Skull, External Approach	N		
X2A7358	Intermittent Coronary Sinus Occlusion, Percutaneous Approach, New Technology Group 8	N**	05	250, 251
XF50X08	Destruction of Liver using Ultrasound-guided Cavitation, External Approach, New Technology Group 8	N**	07	405, 406, 407
XF51X08	Destruction of Right Lobe Liver using Ultrasound-guided Cavitation, External Approach, New Technology Group 8	N**	07	405, 406, 407
XF52X08	Destruction of Left Lobe Liver using Ultrasound-guided Cavitation, External Approach, New Technology Group 8	N**	07	405, 406, 407
XRRG0L8	Replacement of Right Knee Joint with Synthetic Substitute, Lateral Meniscus, Open Approach, New Technology Group 8	Y	08	461, 462, 469, 470
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
XRRG0M8	Replacement of Right Knee Joint with Synthetic Substitute, Medial Meniscus, Open Approach, New Technology Group 8	Y	08	461, 462, 469, 470
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
XRRH0L8	Replacement of Left Knee Joint with Synthetic Substitute, Lateral Meniscus, Open Approach, New Technology Group 8	Y	08	461, 462, 469, 470
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
XRRH0M8	Replacement of Left Knee Joint with Synthetic Substitute, Medial Meniscus, Open Approach, New Technology Group 8	Y	08	461, 462, 469, 470
""			21	907, 908, 909
""			24	957, 958, 959
""				981, 982, 983
XW013V7^	Introduction of COVID-19 Vaccine Dose 3 into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 7	N		
XW013W7^	Introduction of COVID-19 Vaccine Booster into Subcutaneous Tissue, Percutaneous Approach, New Technology Group 7	N		
XW023V7^	Introduction of COVID-19 Vaccine Dose 3 into Muscle, Percutaneous Approach, New Technology Group 7	N		
XW023W7^	Introduction of COVID-19 Vaccine Booster into Muscle, Percutaneous Approach, New Technology Group 7	N		
XW023X7^	Introduction of Tixagevimab and Cilgavimab Monoclonal Antibody into Muscle, Percutaneous Approach, New Technology Group 7	N		
XW023Y7^	Introduction of Other New Technology Monoclonal Antibody into Muscle, Percutaneous Approach, New Technology Group 7	N		
XW0DXR7^	Introduction of Fostamatinib into Mouth and Pharynx, External Approach, New Technology Group 7	N		
XW0G7R7^	Introduction of Fostamatinib into Upper GI, Via Natural or Artificial Opening, New Technology Group 7	N		
XW0H7R7^	Introduction of Fostamatinib into Lower GI, Via Natural or Artificial Opening, New Technology Group 7	N		
XW0H7X8	Introduction of Broad Consortium Microbiota-based Live Biotherapeutic Suspension into Lower GI, Via Natural or Artificial Opening, New Technology Group 8	N		

	Notes:
	(^)-These codes were implemented on April 1, 2022.
	(**)-Non-OR procedure affects DRGs
