ICD-10-PCS 2027 procedure code
04RY4KZReplacement of Lower Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach
Short description: Replacement of Low 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 04RY4KZ
04RY4KZ is the ICD-10-PCS code for a replacement procedure on the lower 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, lower limb arteries, the ICD-9-CM procedure title it maps to (38.48).
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 04RY0KZ (open).
With a different device, use 04RY47Z (autologous tissue substitute) and 04RY4JZ (synthetic 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
- YLower Artery
Includes: Umbilical 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
- 04RA4KZRenal Artery, Left
- 04RB4KZInferior 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 10 · Endocrine, Nutritional and Metabolic Diseases and Disorders · Other Endocrine, Nutritional and Metabolic O.R. 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 →- 38.48Resection of vessel with replacement, 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 04RY4KZ
Is 04RY4KZ a valid ICD-10-PCS code for 2027?
- Yes. 04RY4KZ is valid for inpatient procedures from October 1, 2026 through September 30, 2027.
Is 04RY4KZ an O.R. procedure?
- Yes. 04RY4KZ is an O.R. procedure in MS-DRG v44.0.
What DRG does 04RY4KZ group to?
- Depending on the principal diagnosis, 04RY4KZ 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 04RY4KZ?
- The CMS GEMs map 04RY4KZ to ICD-9-CM 38.48 (Resection of vessel with replacement, lower limb arteries).