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ICD-10-PCS 2027 procedure code

0NRL4KZReplacement of Left Palatine Bone with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Replace L Palatine Bone w Nonaut Sub, Perc Endo

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 0NRL4KZ

0NRL4KZ is the ICD-10-PCS code for a replacement procedure on the left palatine bone 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 bone graft to facial bone, the ICD-9-CM procedure title it maps to (76.91).

For a different body part, codes include 0NR04KZ (skull), 0NR14KZ (frontal bone), 0NR34KZ (right parietal bone), 0NR44KZ (left parietal bone), 0NR54KZ (right temporal bone), 0NR64KZ (left temporal bone) and 16 more.

The same procedure with a different approach is coded 0NRL0KZ (open) and 0NRL3KZ (percutaneous).

With a different device, use 0NRL47Z (autologous tissue substitute) and 0NRL4JZ (synthetic substitute).

It is an operating-room procedure in the MS-DRG logic for DRG 143 (Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC), DRG 144 (Other Ear, Nose, Mouth and Throat O.R. Procedures with CC) and DRG 145 (Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC), under the surgical category “Other Ear, Nose, Mouth and Throat O.R. 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
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
LPalatine Bone, Left
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

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 →
  • 76.91Bone graft to facial boneapproximate

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 0NRL4KZ

Is 0NRL4KZ a valid ICD-10-PCS code for 2027?

Yes. 0NRL4KZ is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 0NRL4KZ an O.R. procedure?

Yes. 0NRL4KZ is an O.R. procedure in MS-DRG v44.0.

What DRG does 0NRL4KZ group to?

Depending on the principal diagnosis, 0NRL4KZ can group to MS-DRG 143, MS-DRG 144 and MS-DRG 145.

What is the ICD-9 procedure code for 0NRL4KZ?

The CMS GEMs map 0NRL4KZ to ICD-9-CM 76.91 (Bone graft to facial bone).