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ICD-10-PCS 2027 procedure code

021R4ADBypass Left Pulmonary Artery from Carotid with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Bypass L Pulm Art from Carotid w Autol Art, Perc Endo

Code last changed in FY2017 (effective October 1, 2016). Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data

About 021R4AD

021R4AD is the ICD-10-PCS code for a bypass procedure on the left pulmonary artery using a percutaneous endoscopic approach with autologous arterial tissue (qualifier: carotid). In ICD-10-PCS, bypass means altering the route of passage of the contents of a tubular body part.

In plain terms, this corresponds to systemic to pulmonary artery shunt, the ICD-9-CM procedure title it maps to (39.0).

For a different body part, codes include 021P4AD (pulmonary trunk), 021Q4AD (right pulmonary artery), 021W4AD (thoracic aorta, descending) and 021X4AD (thoracic aorta, ascending/arch).

The same procedure with a different approach is coded 021R0AD (open).

With a different device, use 021R48D (zooplastic tissue), 021R49D (autologous venous tissue), 021R4JD (synthetic substitute), 021R4KD (nonautologous tissue substitute) and 021R4ZD (no device).

It is an operating-room procedure in the MS-DRG logic for DRG 166 (Other Respiratory System O.R. Procedures with MCC), DRG 167 (Other Respiratory System O.R. Procedures with CC), DRG 168 (Other Respiratory System O.R. Procedures without CC/MCC), DRG 252 (Other Vascular Procedures with MCC), DRG 253 (Other Vascular Procedures with CC) and DRG 254 (Other Vascular Procedures without CC/MCC), under the surgical categories “Other Respiratory System O.R. Procedures”, “Other Vascular Procedures”, “Other O.R. Procedures for Injuries” and 1 more.

It was added in FY2017, effective October 1, 2016.

What each character means

1. Section
0Medical and Surgical
2. Body System
2Heart and Great Vessels
3. Operation
1Bypass

Altering the route of passage of the contents of a tubular body part

Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device

Includes: Coronary artery bypass, colostomy formation

4. Body Part
RPulmonary Artery, Left

Includes: Arterial canal (duct); Botallo's duct; Pulmoaortic canal

5. Approach
4Percutaneous Endoscopic

Entry, by puncture or minor incision, of instrumentation through the skin or mucous membrane and any other body layers necessary to reach and visualize the site of the procedure

6. Device
AAutologous Arterial Tissue
7. Qualifier
DCarotid

Other versions of this procedure

Different approach

MS-DRG v44.0 grouping

All DRGs →

Surgical MS-DRGs this procedure can group to, depending on the principal diagnosis's MDC.

ICD-9-CM equivalent

Converter →
  • 39.0Systemic to pulmonary artery shuntapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2017 (effective 10/1/2016): Added
  • No changes since FY2017.

Common questions about 021R4AD

Is 021R4AD a valid ICD-10-PCS code for 2027?

Yes. 021R4AD is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 021R4AD an O.R. procedure?

Yes. 021R4AD is an O.R. procedure in MS-DRG v44.0.

What DRG does 021R4AD group to?

Depending on the principal diagnosis, 021R4AD can group to MS-DRG 166, MS-DRG 167, MS-DRG 168, MS-DRG 252, MS-DRG 253 and MS-DRG 254.

What is the ICD-9 procedure code for 021R4AD?

The CMS GEMs map 021R4AD to ICD-9-CM 39.0 (Systemic to pulmonary artery shunt).