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Dx

ICD-10-PCS 2027 procedure code

04LE4DVOcclusion of Right Prostatic Artery with Intraluminal Device, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedureMale only

Short description: Occlusion of R Pros A with Intralum Dev, Perc Endo Approach

Code last changed in FY2023 (effective October 1, 2022). Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data

About 04LE4DV

04LE4DV is the ICD-10-PCS code for a occlusion procedure on the right internal iliac artery using a percutaneous endoscopic approach with intraluminal device (qualifier: right prostatic artery). In ICD-10-PCS, occlusion means completely closing an orifice or the lumen of a tubular body part.

The same procedure with a different approach is coded 04LE0DV (open) and 04LE3DV (percutaneous).

With a different device, use 04LE4CV (extraluminal device) and 04LE4ZV (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), DRG 254 (Other Vascular Procedures without CC/MCC), DRG 715 (Male Reproductive System and Other O.R. Procedures for Malignancy with CC/MCC), DRG 716 (Male Reproductive System and Other O.R. Procedures for Malignancy without CC/MCC) and DRG 717 (Other Male Reproductive System O.R. Procedures with CC/MCC), under the surgical categories “Other Vascular Procedures”, “”, “Other Male Reproductive System O.R. Procedures” and 2 more.

It was added in FY2023, effective October 1, 2022.

What each character means

1. Section
0Medical and Surgical
2. Body System
4Lower Arteries
3. Operation
LOcclusion

Completely closing an orifice or the lumen of a tubular body part

The orifice can be a natural orifice or an artificially created orifice

Includes: Fallopian tube ligation, ligation of inferior vena cava

4. Body Part
EInternal Iliac Artery, Right
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
DIntraluminal Device

Includes: Absolute Pro Vascular (OTW) Self-Expanding Stent System; Acculink (RX) Carotid Stent System; AFX(R) Endovascular AAA System; AneuRx(R) AAA Advantage(R); Assurant (Cobalt) stent; Carotid WALLSTENT(R) Monorail(R) Endoprosthesis; CoAxia NeuroFlo catheter; Colonic Z-Stent(R); Complete (SE) stent; Cook Zenith AAA Endovascular Graft; Driver stent (RX) (OTW); E-Luminexx(tm) (Biliary)(Vascular) Stent; Embolization coil(s); Endologix AFX(R) Endovascular AAA System; Endurant(R) Endovascular Stent Graft; Endurant(R) II AAA stent graft system; EXCLUDER(R) AAA Endoprosthesis; Express(R) (LD) Premounted Stent System; Express(R) Biliary SD Monorail(R) Premounted Stent System; Express(R) SD Renal Monorail(R) Premounted Stent System; FLAIR(R) Endovascular Stent Graft; Formula(tm) Balloon-Expandable Renal Stent System; GORE EXCLUDER(R) AAA Endoprosthesis; GORE TAG(R) Thoracic Endoprosthesis; GORE(R) VIABAHN(R) Endoprosthesis; GORE(R) VIABIL(R) Biliary Endoprosthesis; Herculink (RX) Elite Renal Stent System; Innova(tm) stent; LifeStent(R) (Flexstar)(XL) Vascular Stent System; Medtronic Endurant(R) II AAA stent graft system; Micro-Driver stent (RX) (OTW); MULTI-LINK (VISION)(MINI-VISION)(ULTRA) Coronary Stent System; Omnilink Elite Vascular Balloon Expandable Stent System; Protege(R) RX Carotid Stent System; Stent, intraluminal (cardiovascular)(gastrointestinal)(hepatobiliary)(urinary); Talent(R) Converter; Talent(R) Occluder; Talent(R) Stent Graft (abdominal)(thoracic); Therapeutic occlusion coil(s); Ultraflex(tm) Precision Colonic Stent System; Valiant Thoracic Stent Graft; WALLSTENT(R) Endoprosthesis; Xact Carotid Stent System; Zenith AAA Endovascular Graft; Zenith Flex(R) AAA Endovascular Graft; Zenith TX2(R) TAA Endovascular Graft; Zenith(R) Renu(tm) AAA Ancillary Graft

7. Qualifier
VProstatic Artery, Right

Other versions of this procedure

MS-DRG v44.0 grouping

All DRGs →

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

MDC 12 · Diseases and Disorders of the Male Reproductive System · Other Male Reproductive System O.R. Procedures

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
  • FY2023 (effective 10/1/2022): Added
  • No changes since FY2023.

Common questions about 04LE4DV

Is 04LE4DV a valid ICD-10-PCS code for 2027?

Yes. 04LE4DV is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 04LE4DV an O.R. procedure?

Yes. 04LE4DV is an O.R. procedure in MS-DRG v44.0.

What DRG does 04LE4DV group to?

Depending on the principal diagnosis, 04LE4DV can group to MS-DRG 252, MS-DRG 253, MS-DRG 254, MS-DRG 715, MS-DRG 716 and MS-DRG 717.