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ICD-10-PCS 2027 procedure code

021X49RBypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Bypass Thor Aorta Asc to L Pulm Art w Autol Vn, 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 021X49R

021X49R is the ICD-10-PCS code for a bypass procedure on the thoracic aorta, ascending/arch using a percutaneous endoscopic approach with autologous venous tissue (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 021649R (right atrium), 021749R (left atrium), 021K49R (right ventricle), 021L49R (left ventricle), 021V49R (superior vena cava) and 021W49R (thoracic aorta, descending).

The same procedure with a different approach is coded 021X09R (open).

With a different device, use 021X48R (zooplastic tissue), 021X4AR (autologous arterial tissue), 021X4JR (synthetic substitute), 021X4KR (nonautologous tissue substitute) and 021X4ZR (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 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
XThoracic Aorta, Ascending/Arch

Includes: Aortic arch; Aortic isthmus; Aortic root; Ascending aorta; Juxtaductal aorta

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
9Autologous Venous Tissue
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
  • FY2017 (effective 10/1/2016): Added
  • No changes since FY2017.

Common questions about 021X49R

Is 021X49R a valid ICD-10-PCS code for 2027?

Yes. 021X49R is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 021X49R an O.R. procedure?

Yes. 021X49R is an O.R. procedure in MS-DRG v44.0.

What DRG does 021X49R group to?

Depending on the principal diagnosis, 021X49R can group to MS-DRG 270, MS-DRG 271 and MS-DRG 272.

What is the ICD-9 procedure code for 021X49R?

The CMS GEMs map 021X49R to ICD-9-CM 39.0 (Systemic to pulmonary artery shunt).