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ICD-10-PCS 2027 procedure code

0D190Z4Bypass Duodenum to Cutaneous, Open Approach

✓ Valid for 2027O.R. procedure

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 0D190Z4

0D190Z4 is the ICD-10-PCS code for a bypass procedure on the duodenum using an open approach (qualifier: cutaneous). In ICD-10-PCS, bypass means altering the route of passage of the contents of a tubular body part.

In plain terms, this corresponds to Exteriorization of small intestine, the ICD-9-CM procedure title it maps to (46.01).

For a different body part, codes include 0D110Z4 (esophagus, upper), 0D120Z4 (esophagus, middle), 0D130Z4 (esophagus, lower), 0D150Z4 (esophagus), 0D160Z4 (stomach), 0D180Z4 (small intestine) and 8 more.

The same procedure with a different approach is coded 0D194Z4 (percutaneous endoscopic) and 0D198Z4 (via natural or artificial opening endoscopic).

With a different device, use 0D19074 (autologous tissue substitute), 0D190J4 (synthetic substitute) and 0D190K4 (nonautologous tissue substitute).

It is an operating-room procedure in the MS-DRG logic for DRG 329 (Major Small and Large Bowel Procedures with MCC), DRG 330 (Major Small and Large Bowel Procedures with CC), DRG 331 (Major Small and Large Bowel Procedures without CC/MCC), DRG 820 (Lymphoma and Leukemia with Major O.R. Procedures with MCC), DRG 821 (Lymphoma and Leukemia with Major O.R. Procedures with CC) and DRG 822 (Lymphoma and Leukemia with Major O.R. Procedures without CC/MCC), under the surgical categories “Major Small and Large Bowel Procedures”, “Lymphoma and Leukemia with Major O.R. Procedures”, “Myeloproliferative Disorders or Poorly Differentiated Neoplasms with Major O.R. Procedures” and 2 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
DGastrointestinal System
3. Operation
1Bypass

Altering the route of passage of the contents of a tubular body part

Rerouting contents of a body part to a downstream area of the normal route, to a similar route and body part, or to an abnormal route and dissimilar body part. Includes one or more anastomoses, with or without the use of a device

Includes: Coronary artery bypass, colostomy formation

4. Body Part
9Duodenum
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
ZNo Device
7. Qualifier
4Cutaneous

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.

ICD-9-CM equivalent

Converter →
  • 46.01Exteriorization of small intestineapproximate

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 0D190Z4

Is 0D190Z4 a valid ICD-10-PCS code for 2027?

Yes. 0D190Z4 is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 0D190Z4 an O.R. procedure?

Yes. 0D190Z4 is an O.R. procedure in MS-DRG v44.0.

What DRG does 0D190Z4 group to?

Depending on the principal diagnosis, 0D190Z4 can group to MS-DRG 329, MS-DRG 330, MS-DRG 331, MS-DRG 820, MS-DRG 821 and MS-DRG 822.

What is the ICD-9 procedure code for 0D190Z4?

The CMS GEMs map 0D190Z4 to ICD-9-CM 46.01 (Exteriorization of small intestine).