ICD-10-PCS 2027 procedure code
03120ADBypass Innominate Artery to Upper Arm Vein with Autologous Arterial Tissue, Open Approach
Short description: Bypass Innom Art to Up Arm Vein w Autol Art, Open
Code unchanged since ICD-10-PCS took effect on October 1, 2015. Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data
About 03120AD
03120AD is the ICD-10-PCS code for a bypass procedure on the innominate artery using an open approach with autologous arterial tissue (qualifier: upper arm vein). 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 other (peripheral) vascular shunt or bypass, the ICD-9-CM procedure title it maps to (39.29).
For a different body part, codes include 03130AD (right subclavian artery), 03140AD (left subclavian artery), 03150AD (right axillary artery), 03160AD (left axillary artery), 03170AD (right brachial artery) and 03180AD (left brachial artery).
With a different device, use 031209D (autologous venous tissue), 03120JD (synthetic substitute), 03120KD (nonautologous tissue substitute) and 03120ZD (no device).
It is an operating-room procedure in the MS-DRG logic for 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 category “Other Vascular 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
- 3Upper Arteries
- 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
- 2Innominate Artery
Includes: Brachiocephalic artery; Brachiocephalic trunk
- 5. Approach
- 0Open
Cutting through the skin or mucous membrane and any other body layers necessary to expose the site of the procedure
- 6. Device
- AAutologous Arterial Tissue
- 7. Qualifier
- DUpper Arm Vein
Other versions of this procedure
Different body part
Different device
Different qualifier
- 03120A0Upper Arm Artery, Right
- 03120A1Upper Arm Artery, Left
- 03120A2Upper Arm Artery, Bilateral
- 03120A3Lower Arm Artery, Right
- 03120A4Lower Arm Artery, Left
- 03120A5Lower Arm Artery, Bilateral
- 03120A6Upper Leg Artery, Right
- 03120A7Upper Leg Artery, Left
- 03120A8Upper Leg Artery, Bilateral
- 03120A9Lower Leg Artery, Right
- 03120ABLower Leg Artery, Left
- 03120ACLower Leg Artery, Bilateral
MS-DRG v44.0 grouping
All DRGs →Surgical MS-DRGs this procedure can group to, depending on the principal diagnosis's MDC.
MDC 05 · Diseases and Disorders of the Circulatory System · Other Vascular Procedures
ICD-9-CM equivalent
Converter →- 39.29Other (peripheral) vascular shunt or bypassapproximate
From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.
Code history
- 2016
- 2017
- 2018
- 2019
- 2020
- 2021
- 2022
- 2023
- 2024
- 2025
- 2026
- 2027
- FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
- No changes since FY2016.
Common questions about 03120AD
Is 03120AD a valid ICD-10-PCS code for 2027?
- Yes. 03120AD is valid for inpatient procedures from October 1, 2026 through September 30, 2027.
Is 03120AD an O.R. procedure?
- Yes. 03120AD is an O.R. procedure in MS-DRG v44.0.
What DRG does 03120AD group to?
- Depending on the principal diagnosis, 03120AD can group to MS-DRG 252, MS-DRG 253 and MS-DRG 254.
What is the ICD-9 procedure code for 03120AD?
- The CMS GEMs map 03120AD to ICD-9-CM 39.29 (Other (peripheral) vascular shunt or bypass).