ICD-10-PCS 2027 procedure code
04LM0DZOcclusion of Right Popliteal Artery with Intraluminal Device, Open Approach
Short description: Occlusion of R Popl Art with Intralum Dev, Open Approach
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 04LM0DZ
04LM0DZ is the ICD-10-PCS code for a occlusion procedure on the right popliteal artery using an open approach with intraluminal device. In ICD-10-PCS, occlusion means completely closing an orifice or the lumen of a tubular body part.
In plain terms, this corresponds to other surgical occlusion of vessels, lower limb arteries, the ICD-9-CM procedure title it maps to (38.88).
For a different body part, codes include 04L00DZ (abdominal aorta), 04L10DZ (celiac artery), 04L20DZ (gastric artery), 04L30DZ (hepatic artery), 04L40DZ (splenic artery), 04L50DZ (superior mesenteric artery) and 24 more.
The same procedure with a different approach is coded 04LM3DZ (percutaneous) and 04LM4DZ (percutaneous endoscopic).
With a different device, use 04LM0CZ (extraluminal device) and 04LM0ZZ (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 907 (Other O.R. Procedures for Injuries with MCC), DRG 908 (Other O.R. Procedures for Injuries with CC) and DRG 909 (Other O.R. Procedures for Injuries without CC/MCC), under the surgical categories “Other Vascular Procedures”, “Other O.R. Procedures for Injuries” and “Other O.R. Procedures for Multiple Significant Trauma”.
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
- 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
- MPopliteal Artery, Right
- 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
- 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
- ZNo Qualifier
Other versions of this procedure
Different body part
- 04L00DZAbdominal Aorta
- 04L10DZCeliac Artery
- 04L20DZGastric Artery
- 04L30DZHepatic Artery
- 04L40DZSplenic Artery
- 04L50DZSuperior Mesenteric Artery
- 04L60DZColic Artery, Right
- 04L70DZColic Artery, Left
- 04L80DZColic Artery, Middle
- 04L90DZRenal Artery, Right
- 04LA0DZRenal Artery, Left
- 04LB0DZInferior Mesenteric Artery
Different approach
Different device
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
MDC 21 · Injuries, Poisonings and Toxic Effects of Drugs · Other O.R. Procedures for Injuries
MDC 24 · Multiple Significant Trauma · Other O.R. Procedures for Multiple Significant Trauma
ICD-9-CM equivalent
Converter →- 38.88Other surgical occlusion of vessels, lower limb arteriesapproximate
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 04LM0DZ
Is 04LM0DZ a valid ICD-10-PCS code for 2027?
- Yes. 04LM0DZ is valid for inpatient procedures from October 1, 2026 through September 30, 2027.
Is 04LM0DZ an O.R. procedure?
- Yes. 04LM0DZ is an O.R. procedure in MS-DRG v44.0.
What DRG does 04LM0DZ group to?
- Depending on the principal diagnosis, 04LM0DZ can group to MS-DRG 252, MS-DRG 253, MS-DRG 254, MS-DRG 907, MS-DRG 908 and MS-DRG 909.
What is the ICD-9 procedure code for 04LM0DZ?
- The CMS GEMs map 04LM0DZ to ICD-9-CM 38.88 (Other surgical occlusion of vessels, lower limb arteries).