ICD-10-PCS 2027 procedure code
04RA4KZReplacement of Left Renal Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
Short description: Replace of L Renal Art with Nonaut Sub, Perc Endo 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 04RA4KZ
04RA4KZ is the ICD-10-PCS code for a replacement procedure on the left renal artery using a percutaneous endoscopic approach with nonautologous tissue substitute. In ICD-10-PCS, replacement means putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part.
In plain terms, this corresponds to resection of vessel with replacement, abdominal arteries, the ICD-9-CM procedure title it maps to (38.46).
For a different body part, codes include 04R04KZ (abdominal aorta), 04R14KZ (celiac artery), 04R24KZ (gastric artery), 04R34KZ (hepatic artery), 04R44KZ (splenic artery), 04R54KZ (superior mesenteric artery) and 24 more.
The same procedure with a different approach is coded 04RA0KZ (open).
With a different device, use 04RA47Z (autologous tissue substitute) and 04RA4JZ (synthetic substitute).
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), DRG 272 (Other Major Cardiovascular Procedures without CC/MCC), DRG 673 (Other Kidney and Urinary Tract Procedures with MCC), DRG 674 (Other Kidney and Urinary Tract Procedures with CC) and DRG 675 (Other Kidney and Urinary Tract Procedures without CC/MCC), under the surgical categories “Other Major Cardiovascular Procedures” and “Other Kidney and Urinary Tract 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
- 4Lower Arteries
- 3. Operation
- RReplacement
Putting in or on biological or synthetic material that physically takes the place and/or function of all or a portion of a body part
The body part may have been taken out or replaced, or may be taken out, physically eradicated, or rendered nonfunctional during the Replacement procedure. A Removal procedure is coded for taking out the device used in a previous replacement procedure
Includes: Total hip replacement, bone graft, free skin graft
- 4. Body Part
- ARenal Artery, Left
Includes: Inferior suprarenal artery; Renal segmental artery
- 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
- KNonautologous Tissue Substitute
Includes: Acellular Hydrated Dermis; Bone bank bone graft; Cook Biodesign(R) Fistula Plug(s); Cook Biodesign(R) Hernia Graft(s); Cook Biodesign(R) Layered Graft(s); Cook Zenapro(tm) Layered Graft(s); Fish skin; Kerecis(R) (GraftGuide) (MariGen) (SurgiBind) (SurgiClose); MIRODERM(tm) Biologic Wound Matrix; Piscine skin; Tissue bank graft
- 7. Qualifier
- ZNo Qualifier
Other versions of this procedure
Different body part
- 04R04KZAbdominal Aorta
- 04R14KZCeliac Artery
- 04R24KZGastric Artery
- 04R34KZHepatic Artery
- 04R44KZSplenic Artery
- 04R54KZSuperior Mesenteric Artery
- 04R64KZColic Artery, Right
- 04R74KZColic Artery, Left
- 04R84KZColic Artery, Middle
- 04R94KZRenal Artery, Right
- 04RB4KZInferior Mesenteric Artery
- 04RC4KZCommon Iliac Artery, Right
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 Major Cardiovascular Procedures
MDC 11 · Diseases and Disorders of the Kidney and Urinary Tract · Other Kidney and Urinary Tract Procedures
ICD-9-CM equivalent
Converter →- 38.46Resection of vessel with replacement, abdominal 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 04RA4KZ
Is 04RA4KZ a valid ICD-10-PCS code for 2027?
- Yes. 04RA4KZ is valid for inpatient procedures from October 1, 2026 through September 30, 2027.
Is 04RA4KZ an O.R. procedure?
- Yes. 04RA4KZ is an O.R. procedure in MS-DRG v44.0.
What DRG does 04RA4KZ group to?
- Depending on the principal diagnosis, 04RA4KZ can group to MS-DRG 270, MS-DRG 271, MS-DRG 272, MS-DRG 673, MS-DRG 674 and MS-DRG 675.
What is the ICD-9 procedure code for 04RA4KZ?
- The CMS GEMs map 04RA4KZ to ICD-9-CM 38.46 (Resection of vessel with replacement, abdominal arteries).