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ICD-10-PCS 2027 procedure code

0NP0X4ZRemoval of Internal Fixation Device from Skull, External Approach

✓ Valid for 2027O.R. procedure

Short description: Removal of Int Fix from Skull, Extern 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 0NP0X4Z

0NP0X4Z is the ICD-10-PCS code for a removal procedure on the skull using an external approach with internal fixation device. In ICD-10-PCS, removal means taking out or off a device from a body part.

In plain terms, this corresponds to other craniotomy, the ICD-9-CM procedure title it maps to (01.24).

For a different body part, codes include 0NPBX4Z (nasal bone) and 0NPWX4Z (facial bone).

The same procedure with a different approach is coded 0NP004Z (open), 0NP034Z (percutaneous) and 0NP044Z (percutaneous endoscopic).

With a different device, use 0NP0X0Z (drainage device), 0NP0X3Z (infusion device), 0NP0X5Z (external fixation device), 0NP0XMZ (bone growth stimulator) and 0NP0XSZ (hearing device).

It is an operating-room procedure in the MS-DRG logic for DRG 023 (Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis with MCC or Antineoplastic Implant or Epilepsy with Neurostimulator), DRG 024 (Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis without MCC), DRG 025 (Craniotomy and Endovascular Intracranial Procedures with MCC), DRG 026 (Craniotomy and Endovascular Intracranial Procedures with CC) and DRG 027 (Craniotomy and Endovascular Intracranial Procedures without CC/MCC), under the surgical categories “Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis” and “Craniotomy and endovascular intracranial 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
NHead and Facial Bones
3. Operation
PRemoval

Taking out or off a device from a body part

If a device is taken out and a similar device put in without cutting or puncturing the skin or mucous membrane, the procedure is coded to the root operation CHANGE. Otherwise, the procedure for taking out a device is coded to the root operation REMOVAL

Includes: Drainage tube removal, cardiac pacemaker removal

4. Body Part
0Skull
5. Approach
XExternal

Procedures performed directly on the skin or mucous membrane and procedures performed indirectly by the application of external force through the skin or mucous membrane

6. Device
4Internal Fixation Device
7. Qualifier
ZNo Qualifier

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 →
  • 01.24Other craniotomyapproximate

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 0NP0X4Z

Is 0NP0X4Z a valid ICD-10-PCS code for 2027?

Yes. 0NP0X4Z is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 0NP0X4Z an O.R. procedure?

Yes. 0NP0X4Z is an O.R. procedure in MS-DRG v44.0.

What DRG does 0NP0X4Z group to?

Depending on the principal diagnosis, 0NP0X4Z can group to MS-DRG 023, MS-DRG 024, MS-DRG 025, MS-DRG 026 and MS-DRG 027.

What is the ICD-9 procedure code for 0NP0X4Z?

The CMS GEMs map 0NP0X4Z to ICD-9-CM 01.24 (Other craniotomy).