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ICD-10-PCS 2027 procedure code

021X4ZABypass Thoracic Aorta, Ascending/Arch to Innominate Artery, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Bypass Thor Aorta Asc to Innom Art, Perc Endo Approach

Code last changed in FY2020 (effective October 1, 2019). Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data

About 021X4ZA

021X4ZA is the ICD-10-PCS code for a bypass procedure on the thoracic aorta, ascending/arch using a percutaneous endoscopic approach (qualifier: innominate artery). In ICD-10-PCS, bypass means altering the route of passage of the contents of a tubular body part.

For a different body part, codes include 021P4ZA (pulmonary trunk), 021Q4ZA (right pulmonary artery), 021R4ZA (left pulmonary artery) and 021W4ZA (thoracic aorta, descending).

The same procedure with a different approach is coded 021X0ZA (open).

With a different device, use 021X48A (zooplastic tissue), 021X49A (autologous venous tissue), 021X4AA (autologous arterial tissue), 021X4JA (synthetic substitute) and 021X4KA (nonautologous tissue substitute).

It is an operating-room procedure in the MS-DRG logic for DRG 037 (Extracranial Procedures with MCC), DRG 038 (Extracranial Procedures with CC), DRG 039 (Extracranial Procedures without CC/MCC), 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 categories “Extracranial Procedures”, “Other Major Cardiovascular Procedures”, “Other O.R. Procedures for Injuries” and 1 more.

It was added in FY2020, effective October 1, 2019.

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
ZNo Device
7. Qualifier
AInnominate Artery

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.

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
  • FY2020 (effective 10/1/2019): Added
  • No changes since FY2020.

Common questions about 021X4ZA

Is 021X4ZA a valid ICD-10-PCS code for 2027?

Yes. 021X4ZA is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 021X4ZA an O.R. procedure?

Yes. 021X4ZA is an O.R. procedure in MS-DRG v44.0.

What DRG does 021X4ZA group to?

Depending on the principal diagnosis, 021X4ZA can group to MS-DRG 037, MS-DRG 038, MS-DRG 039, MS-DRG 270, MS-DRG 271 and MS-DRG 272.