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ICD-10-PCS 2027 procedure code

04RL4JZReplacement of Left Femoral Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Replacement of L Fem Art with Synth 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 04RL4JZ

04RL4JZ is the ICD-10-PCS code for a replacement procedure on the left femoral artery using a percutaneous endoscopic approach with synthetic 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, lower limb arteries, the ICD-9-CM procedure title it maps to (38.48).

For a different body part, codes include 04R04JZ (abdominal aorta), 04R14JZ (celiac artery), 04R24JZ (gastric artery), 04R34JZ (hepatic artery), 04R44JZ (splenic artery), 04R54JZ (superior mesenteric artery) and 24 more.

The same procedure with a different approach is coded 04RL0JZ (open).

With a different device, use 04RL47Z (autologous tissue substitute) and 04RL4KZ (nonautologous tissue substitute).

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 628 (Other Endocrine, Nutritional and Metabolic O.R. Procedures with MCC or Insertion of Antibiotic-eluting Bone Void Filler), DRG 629 (Other Endocrine, Nutritional and Metabolic O.R. Procedures with CC) and DRG 630 (Other Endocrine, Nutritional and Metabolic O.R. Procedures without CC/MCC), under the surgical categories “Other Vascular Procedures”, “Other Endocrine, Nutritional and Metabolic O.R. Procedures”, “Other O.R. Procedures for Injuries” and 1 more.

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
LFemoral Artery, Left

Includes: Circumflex iliac artery; Deep femoral artery; Descending genicular artery; External pudendal artery; Superficial epigastric 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
JSynthetic Substitute

Includes: AbioCor(R) Total Replacement Heart; AMPLATZER(R) Muscular VSD Occluder; Annuloplasty ring; Bard(R) Composix(R) (E/X)(LP) mesh; Bard(R) Composix(R) Kugel(R) patch; Bard(R) Dulex(tm) mesh; Bard(R) Ventralex(tm) hernia patch; Barricaid(R) Annular Closure Device (ACD); BRYAN(R) Cervical Disc System; Corvia IASD(R); Ex-PRESS(tm) mini glaucoma shunt; Flexible Composite Mesh; GORE(R) ACUSEAL Vascular Graft; GORE(R) CARDIOFORM Septal Occluder; GORE(R) DUALMESH(R); GORE(R) PROPATEN(R) Vascular Graft; GORE(R) VIATORR(R) TIPS Endoprosthesis; Holter valve ventricular shunt; IASD(R) (InterAtrial Shunt Device), Corvia; InterAtrial Shunt Device IASD(R), Corvia; LimFlow(tm) Transcatheter Arterialization of the Deep Veins (TADV) System; MitraClip valve repair system; Nitinol framed polymer mesh; Open Pivot (mechanical) valve; Open Pivot Aortic Valve Graft (AVG); Partially absorbable mesh; PHYSIOMESH(tm) Flexible Composite Mesh; Polymethylmethacrylate (PMMA); Polypropylene mesh; PRESTIGE(R) Cervical Disc; PROCEED(tm) Ventral Patch; Prodisc-C; Prodisc-L; PROLENE Polypropylene Hernia System (PHS); Rebound HRD(R) (Hernia Repair Device); SynCardia Total Artificial Heart; Total artificial (replacement) heart; ULTRAPRO Hernia System (UHS); ULTRAPRO Partially Absorbable Lightweight Mesh; ULTRAPRO Plug; V-Wave Interatrial Shunt System; Ventrio(tm) Hernia Patch; Zimmer(R) NexGen(R) LPS Mobile Bearing Knee; Zimmer(R) NexGen(R) LPS-Flex Mobile Knee

7. Qualifier
ZNo Qualifier

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.

ICD-9-CM equivalent

Converter →
  • 38.48Resection of vessel with replacement, lower limb arteriesapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

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
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about 04RL4JZ

Is 04RL4JZ a valid ICD-10-PCS code for 2027?

Yes. 04RL4JZ is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 04RL4JZ an O.R. procedure?

Yes. 04RL4JZ is an O.R. procedure in MS-DRG v44.0.

What DRG does 04RL4JZ group to?

Depending on the principal diagnosis, 04RL4JZ can group to MS-DRG 252, MS-DRG 253, MS-DRG 254, MS-DRG 628, MS-DRG 629 and MS-DRG 630.

What is the ICD-9 procedure code for 04RL4JZ?

The CMS GEMs map 04RL4JZ to ICD-9-CM 38.48 (Resection of vessel with replacement, lower limb arteries).