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ICD-10-PCS 2027 procedure code

021W4JRBypass Thoracic Aorta, Descending to Left Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Bypass Thor Aorta Desc to L Pulm Art w Synth Sub, 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 021W4JR

021W4JR is the ICD-10-PCS code for a bypass procedure on the thoracic aorta, descending using a percutaneous endoscopic approach with synthetic substitute (qualifier: left pulmonary artery). 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 02164JR (right atrium), 02174JR (left atrium), 021K4JR (right ventricle), 021L4JR (left ventricle), 021V4JR (superior vena cava) and 021X4JR (thoracic aorta, ascending/arch).

The same procedure with a different approach is coded 021W0JR (open).

With a different device, use 021W48R (zooplastic tissue), 021W49R (autologous venous tissue), 021W4AR (autologous arterial tissue), 021W4KR (nonautologous tissue substitute) and 021W4ZR (no device).

It is an operating-room procedure in the MS-DRG logic for DRG 270 (Other Major Cardiovascular Procedures with MCC), DRG 271 (Other Major Cardiovascular Procedures with CC) and DRG 272 (Other Major Cardiovascular Procedures without CC/MCC), under the surgical category “Other Major Cardiovascular Procedures”.

It has been valid since ICD-10-PCS took effect on October 1, 2015.

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
WThoracic Aorta, Descending
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
JSynthetic Substitute

Includes: AbioCor(R) Total Replacement Heart; AMPLATZER(R) Muscular VSD Occluder; Annuloplasty ring; Bard(R) Composix(R) (E/X)(LP) mesh; Bard(R) Composix(R) Kugel(R) patch; Bard(R) Dulex(tm) mesh; Bard(R) Ventralex(tm) hernia patch; Barricaid(R) Annular Closure Device (ACD); BRYAN(R) Cervical Disc System; Corvia IASD(R); Ex-PRESS(tm) mini glaucoma shunt; Flexible Composite Mesh; GORE(R) ACUSEAL Vascular Graft; GORE(R) CARDIOFORM Septal Occluder; GORE(R) DUALMESH(R); GORE(R) PROPATEN(R) Vascular Graft; GORE(R) VIATORR(R) TIPS Endoprosthesis; Holter valve ventricular shunt; IASD(R) (InterAtrial Shunt Device), Corvia; InterAtrial Shunt Device IASD(R), Corvia; LimFlow(tm) Transcatheter Arterialization of the Deep Veins (TADV) System; MitraClip valve repair system; Nitinol framed polymer mesh; Open Pivot (mechanical) valve; Open Pivot Aortic Valve Graft (AVG); Partially absorbable mesh; PHYSIOMESH(tm) Flexible Composite Mesh; Polymethylmethacrylate (PMMA); Polypropylene mesh; PRESTIGE(R) Cervical Disc; PROCEED(tm) Ventral Patch; Prodisc-C; Prodisc-L; PROLENE Polypropylene Hernia System (PHS); Rebound HRD(R) (Hernia Repair Device); SynCardia Total Artificial Heart; Total artificial (replacement) heart; ULTRAPRO Hernia System (UHS); ULTRAPRO Partially Absorbable Lightweight Mesh; ULTRAPRO Plug; V-Wave Interatrial Shunt System; Ventrio(tm) Hernia Patch; Zimmer(R) NexGen(R) LPS Mobile Bearing Knee; Zimmer(R) NexGen(R) LPS-Flex Mobile Knee

7. Qualifier
RPulmonary Artery, Left

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
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • FY2017 (effective 10/1/2016): Title revised — was “Bypass Thoracic Aorta to Left Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach”

Common questions about 021W4JR

Is 021W4JR a valid ICD-10-PCS code for 2027?

Yes. 021W4JR is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 021W4JR an O.R. procedure?

Yes. 021W4JR is an O.R. procedure in MS-DRG v44.0.

What DRG does 021W4JR group to?

Depending on the principal diagnosis, 021W4JR can group to MS-DRG 270, MS-DRG 271 and MS-DRG 272.

What is the ICD-9 procedure code for 021W4JR?

The CMS GEMs map 021W4JR to ICD-9-CM 39.0 (Systemic to pulmonary artery shunt).