SHIFT SLS ValueSets Implementation Guide
0.1.0 - ci-build

SHIFT SLS ValueSets Implementation Guide, published by SHIFT-Task-Force. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/SHIFT-Task-Force/SLS-ValueSets/ and changes regularly. See the Directory of published versions

## ValueSet: Gender-Affirming Care Codes (Health Net California)

Official URL: http://SHIFT-Task-Force.github.io/slsValueSets/ValueSet/AB352GenderAffirmingCareHealthNet | Version: 0.1.0
Active as of 2024-01-01 | Computable Name: AB352GenderAffirmingCareHealthNet
Usage:Clinical Focus: Gender-affirming care

CPT and ICD-10-CM codes referenced in Health Net California's clinical policy 'HNCA.CP.MP.496 - Gender Affirming Procedures'. Intended for segmentation of gender-affirming care under AB352.

Health Net Bulletin 24-351

Health Net's bulletin 24-351 explicitly tells providers that services defined in policies like HNCA.CP.MP.496 must be:

- Blocked from automatic sharing with the California Data Exchange Framework (DxF).
- Omitted from responses to out-of-state subpoenas or investigations.
- Flagged within the EHR to prevent unauthorized access by users outside of California.

Where to Find and Download HNCA.CP.MP.496.pdf Health Net maintains this policy in several locations within their provider libraries:

- Direct PDF Link: HNCA.CP.MP.496 - Gender Affirming Procedures
- The Provider Library Archive: You can find this by navigating to Health Net Provider Library > Resources > Clinical Policies and searching for `Gender Affirming Procedures` or the code `496.`

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

### Logical Definition (CLD)

- Include these codes as defined in `http://www.ama-assn.org/go/cpt` version Not Stated (use latest from terminology server)

  Code | Display
  11960 | Insertion of tissue expander(s) for other than breast, including subsequent expansion
  11950 | Subcutaneous injection of filling material (eg, collagen); 1 cc or less
  11951 | Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc
  11952 | Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc
  11954 | Subcutaneous injection of filling material (eg, collagen); over 10.0 cc
  11970 | Replacement of tissue expander with permanent implant
  14000 | Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less
  14001 | Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm
  14040 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less
  14041 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm
  15100 | Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
  15101 | Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
  15120 | Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050)
  15121 | Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure)
  15200 | Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less
  15570 | Formation of direct or tubed pedicle, with or without transfer; trunk
  15574 | Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet
  15600 | Delay of flap or sectioning of flap (division and inset); at trunk
  15620 | Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet
  15757 | Free skin flap with microvascular anastomosis
  15758 | Free fascial flap with microvascular anastomosis
  15775 | Punch graft for hair transplant; 1 to 15 punch grafts
  15776 | Punch graft for hair transplant; more than 15 punch grafts
  15780 | Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis)
  15781 | Dermabrasion; segmental, face
  15782 | Dermabrasion; regional, other than face
  15783 | Dermabrasion; superficial, any site (eg, tattoo removal)
  15786 | Abrasion; single lesion (eg, keratosis, scar)
  15787 | Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure)
  15788 | Chemical peel, facial; epidermal
  15789 | Chemical peel, facial; dermal
  15792 | Chemical peel, nonfacial; epidermal
  15793 | Chemical peel, nonfacial; dermal
  15820 | Blepharoplasty, lower eyelid;
  15821 | Blepharoplasty, lower eyelid; with extensive herniated fat pad
  15822 | Blepharoplasty, upper eyelid;
  15823 | Blepharoplasty, upper eyelid; with excessive skin weighting down lid
  15824 | Rhytidectomy; forehead
  15825 | Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap)
  15826 | Rhytidectomy; glabellar frown lines
  15828 | Rhytidectomy; cheek, chin, and neck
  15829 | Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap
  15830 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy
  15832 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh
  15833 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg
  15834 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip
  15835 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock
  15836 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm
  15837 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand
  15838 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad
  15839 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area
  15876 | Suction assisted lipectomy; head and neck
  15877 | Suction assisted lipectomy; trunk
  15878 | Suction assisted lipectomy; upper extremity
  15879 | Suction assisted lipectomy; lower extremity
  17380 | Electrolysis epilation, each 30 minutes
  19300 | Mastectomy for gynecomastia
  19301 | Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);
  19303 | Mastectomy, simple, complete
  19316 | Mastopexy
  19318 | Breast reduction
  19325 | Breast augmentation with implant
  19350 | Nipple/areola reconstruction
  21120 | Genioplasty; augmentation (autograft, allograft, prosthetic material)
  21121 | Genioplasty; sliding osteotomy, single piece
  21122 | Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin)
  21123 | Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts)
  21125 | Augmentation, mandibular body or angle; prosthetic material
  21127 | Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft)
  21208 | Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant)
  21209 | Osteoplasty, facial bones; reduction
  21210 | Graft, bone; nasal, maxillary or malar areas (includes obtaining graft)
  21270 | Malar augmentation, prosthetic material
  30400 | Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip
  30410 | Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip
  30420 | Rhinoplasty, primary; including major septal repair
  30430 | Rhinoplasty, secondary; minor revision (small amount of nasal tip work)
  30435 | Rhinoplasty, secondary; intermediate revision (bony work with osteotomies)
  30450 | Rhinoplasty, secondary; major revision (nasal tip work and osteotomies)
  31580 | Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion
  31587 | Laryngoplasty, cricoid split, without graft placement
  31599 | Unlisted procedure, larynx
  31899 | Unlisted procedure, trachea, bronchi
  44145 | Colectomy, partial; with coloproctostomy (low pelvic anastomosis)
  53400 | Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type)
  53405 | Urethroplasty; second stage (formation of urethra), including urinary diversion
  53410 | Urethroplasty, 1-stage reconstruction of male anterior urethra
  53415 | Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra
  53420 | Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage
  53425 | Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage
  53430 | Urethroplasty, reconstruction of female urethra
  53460 | Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure)
  54125 | Amputation of penis; complete
  54340 | Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple
  54400 | Insertion of penile prosthesis; non-inflatable (semi-rigid)
  54401 | Insertion of penile prosthesis; inflatable (self-contained)
  54405 | Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir
  54406 | Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis
  54408 | Repair of component(s) of a multi-component, inflatable penile prosthesis
  54410 | Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session
  54411 | Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
  54415 | Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis
  54416 | Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session
  54417 | Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue
  54520 | Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach
  54660 | Insertion of testicular prosthesis (separate procedure)
  54690 | Laparoscopy, surgical; orchiectomy
  55175 | Scrotoplasty; simple
  55180 | Scrotoplasty; complicated
  55970 | Intersex surgery; male to female
  55980 | Intersex surgery; female to male
  56625 | Vulvectomy simple; complete
  56800 | Plastic repair of introitus
  56805 | Clitoroplasty for intersex state
  56810 | Perineoplasty, repair of perineum, nonobstetrical (separate procedure)
  57106 | Vaginectomy, partial removal of vaginal wall;
  57107 | Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
  57110 | Vaginectomy, complete removal of vaginal wall;
  57111 | Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy)
  57291 | Construction of artificial vagina; without graft
  57292 | Construction of artificial vagina; with graft
  57295 | Revision (including removal) of prosthetic vaginal graft; vaginal approach
  57296 | Revision (including removal) of prosthetic vaginal graft; open abdominal approach
  57335 | Vaginoplasty for intersex state
  57426 | Revision (including removal) of prosthetic vaginal graft, laparoscopic approach
  58150 | Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s);
  58180 | Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s)
  58260 | Vaginal hysterectomy, for uterus 250 g or less;
  58262 | Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)
  58263 | Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele
  58267 | Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control
  58270 | Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele
  58275 | Vaginal hysterectomy, with total or partial vaginectomy;
  58280 | Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele
  58285 | Vaginal hysterectomy, radical (Schauta type operation)

### Expansion

Expansion from tx.fhir.org based on codesystem cpt version 2023

This value set contains 135 concepts

System | Code | Display (en) | JSON | XML
`http://www.ama-assn.org/go/cpt` | 11960 | Insertion of tissue expander(s) for other than breast, including subsequent expansion |  |
`http://www.ama-assn.org/go/cpt` | 11950 | Subcutaneous injection of filling material (eg, collagen); 1 cc or less |  |
`http://www.ama-assn.org/go/cpt` | 11951 | Subcutaneous injection of filling material (eg, collagen); 1.1 to 5.0 cc |  |
`http://www.ama-assn.org/go/cpt` | 11952 | Subcutaneous injection of filling material (eg, collagen); 5.1 to 10.0 cc |  |
`http://www.ama-assn.org/go/cpt` | 11954 | Subcutaneous injection of filling material (eg, collagen); over 10.0 cc |  |
`http://www.ama-assn.org/go/cpt` | 11970 | Replacement of tissue expander with permanent implant |  |
`http://www.ama-assn.org/go/cpt` | 14000 | Adjacent tissue transfer or rearrangement, trunk; defect 10 sq cm or less |  |
`http://www.ama-assn.org/go/cpt` | 14001 | Adjacent tissue transfer or rearrangement, trunk; defect 10.1 sq cm to 30.0 sq cm |  |
`http://www.ama-assn.org/go/cpt` | 14040 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10 sq cm or less |  |
`http://www.ama-assn.org/go/cpt` | 14041 | Adjacent tissue transfer or rearrangement, forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands and/or feet; defect 10.1 sq cm to 30.0 sq cm |  |
`http://www.ama-assn.org/go/cpt` | 15100 | Split-thickness autograft, trunk, arms, legs; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) |  |
`http://www.ama-assn.org/go/cpt` | 15101 | Split-thickness autograft, trunk, arms, legs; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) |  |
`http://www.ama-assn.org/go/cpt` | 15120 | Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; first 100 sq cm or less, or 1% of body area of infants and children (except 15050) |  |
`http://www.ama-assn.org/go/cpt` | 15121 | Split-thickness autograft, face, scalp, eyelids, mouth, neck, ears, orbits, genitalia, hands, feet, and/or multiple digits; each additional 100 sq cm, or each additional 1% of body area of infants and children, or part thereof (List separately in addition to code for primary procedure) |  |
`http://www.ama-assn.org/go/cpt` | 15200 | Full thickness graft, free, including direct closure of donor site, trunk; 20 sq cm or less |  |
`http://www.ama-assn.org/go/cpt` | 15570 | Formation of direct or tubed pedicle, with or without transfer; trunk |  |
`http://www.ama-assn.org/go/cpt` | 15574 | Formation of direct or tubed pedicle, with or without transfer; forehead, cheeks, chin, mouth, neck, axillae, genitalia, hands or feet |  |
`http://www.ama-assn.org/go/cpt` | 15600 | Delay of flap or sectioning of flap (division and inset); at trunk |  |
`http://www.ama-assn.org/go/cpt` | 15620 | Delay of flap or sectioning of flap (division and inset); at forehead, cheeks, chin, neck, axillae, genitalia, hands, or feet |  |
`http://www.ama-assn.org/go/cpt` | 15757 | Free skin flap with microvascular anastomosis |  |
`http://www.ama-assn.org/go/cpt` | 15758 | Free fascial flap with microvascular anastomosis |  |
`http://www.ama-assn.org/go/cpt` | 15775 | Punch graft for hair transplant; 1 to 15 punch grafts |  |
`http://www.ama-assn.org/go/cpt` | 15776 | Punch graft for hair transplant; more than 15 punch grafts |  |
`http://www.ama-assn.org/go/cpt` | 15780 | Dermabrasion; total face (eg, for acne scarring, fine wrinkling, rhytids, general keratosis) |  |
`http://www.ama-assn.org/go/cpt` | 15781 | Dermabrasion; segmental, face |  |
`http://www.ama-assn.org/go/cpt` | 15782 | Dermabrasion; regional, other than face |  |
`http://www.ama-assn.org/go/cpt` | 15783 | Dermabrasion; superficial, any site (eg, tattoo removal) |  |
`http://www.ama-assn.org/go/cpt` | 15786 | Abrasion; single lesion (eg, keratosis, scar) |  |
`http://www.ama-assn.org/go/cpt` | 15787 | Abrasion; each additional 4 lesions or less (List separately in addition to code for primary procedure) |  |
`http://www.ama-assn.org/go/cpt` | 15788 | Chemical peel, facial; epidermal |  |
`http://www.ama-assn.org/go/cpt` | 15789 | Chemical peel, facial; dermal |  |
`http://www.ama-assn.org/go/cpt` | 15792 | Chemical peel, nonfacial; epidermal |  |
`http://www.ama-assn.org/go/cpt` | 15793 | Chemical peel, nonfacial; dermal |  |
`http://www.ama-assn.org/go/cpt` | 15820 | Blepharoplasty, lower eyelid; |  |
`http://www.ama-assn.org/go/cpt` | 15821 | Blepharoplasty, lower eyelid; with extensive herniated fat pad |  |
`http://www.ama-assn.org/go/cpt` | 15822 | Blepharoplasty, upper eyelid; |  |
`http://www.ama-assn.org/go/cpt` | 15823 | Blepharoplasty, upper eyelid; with excessive skin weighting down lid |  |
`http://www.ama-assn.org/go/cpt` | 15824 | Rhytidectomy; forehead |  |
`http://www.ama-assn.org/go/cpt` | 15825 | Rhytidectomy; neck with platysmal tightening (platysmal flap, P-flap) |  |
`http://www.ama-assn.org/go/cpt` | 15826 | Rhytidectomy; glabellar frown lines |  |
`http://www.ama-assn.org/go/cpt` | 15828 | Rhytidectomy; cheek, chin, and neck |  |
`http://www.ama-assn.org/go/cpt` | 15829 | Rhytidectomy; superficial musculoaponeurotic system (SMAS) flap |  |
`http://www.ama-assn.org/go/cpt` | 15830 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); abdomen, infraumbilical panniculectomy |  |
`http://www.ama-assn.org/go/cpt` | 15832 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); thigh |  |
`http://www.ama-assn.org/go/cpt` | 15833 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); leg |  |
`http://www.ama-assn.org/go/cpt` | 15834 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); hip |  |
`http://www.ama-assn.org/go/cpt` | 15835 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); buttock |  |
`http://www.ama-assn.org/go/cpt` | 15836 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); arm |  |
`http://www.ama-assn.org/go/cpt` | 15837 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); forearm or hand |  |
`http://www.ama-assn.org/go/cpt` | 15838 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); submental fat pad |  |
`http://www.ama-assn.org/go/cpt` | 15839 | Excision, excessive skin and subcutaneous tissue (includes lipectomy); other area |  |
`http://www.ama-assn.org/go/cpt` | 15876 | Suction assisted lipectomy; head and neck |  |
`http://www.ama-assn.org/go/cpt` | 15877 | Suction assisted lipectomy; trunk |  |
`http://www.ama-assn.org/go/cpt` | 15878 | Suction assisted lipectomy; upper extremity |  |
`http://www.ama-assn.org/go/cpt` | 15879 | Suction assisted lipectomy; lower extremity |  |
`http://www.ama-assn.org/go/cpt` | 17380 | Electrolysis epilation, each 30 minutes |  |
`http://www.ama-assn.org/go/cpt` | 19300 | Mastectomy for gynecomastia |  |
`http://www.ama-assn.org/go/cpt` | 19301 | Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); |  |
`http://www.ama-assn.org/go/cpt` | 19303 | Mastectomy, simple, complete |  |
`http://www.ama-assn.org/go/cpt` | 19316 | Mastopexy |  |
`http://www.ama-assn.org/go/cpt` | 19318 | Breast reduction |  |
`http://www.ama-assn.org/go/cpt` | 19325 | Breast augmentation with implant |  |
`http://www.ama-assn.org/go/cpt` | 19350 | Nipple/areola reconstruction |  |
`http://www.ama-assn.org/go/cpt` | 21120 | Genioplasty; augmentation (autograft, allograft, prosthetic material) |  |
`http://www.ama-assn.org/go/cpt` | 21121 | Genioplasty; sliding osteotomy, single piece |  |
`http://www.ama-assn.org/go/cpt` | 21122 | Genioplasty; sliding osteotomies, 2 or more osteotomies (eg, wedge excision or bone wedge reversal for asymmetrical chin) |  |
`http://www.ama-assn.org/go/cpt` | 21123 | Genioplasty; sliding, augmentation with interpositional bone grafts (includes obtaining autografts) |  |
`http://www.ama-assn.org/go/cpt` | 21125 | Augmentation, mandibular body or angle; prosthetic material |  |
`http://www.ama-assn.org/go/cpt` | 21127 | Augmentation, mandibular body or angle; with bone graft, onlay or interpositional (includes obtaining autograft) |  |
`http://www.ama-assn.org/go/cpt` | 21208 | Osteoplasty, facial bones; augmentation (autograft, allograft, or prosthetic implant) |  |
`http://www.ama-assn.org/go/cpt` | 21209 | Osteoplasty, facial bones; reduction |  |
`http://www.ama-assn.org/go/cpt` | 21210 | Graft, bone; nasal, maxillary or malar areas (includes obtaining graft) |  |
`http://www.ama-assn.org/go/cpt` | 21270 | Malar augmentation, prosthetic material |  |
`http://www.ama-assn.org/go/cpt` | 30400 | Rhinoplasty, primary; lateral and alar cartilages and/or elevation of nasal tip |  |
`http://www.ama-assn.org/go/cpt` | 30410 | Rhinoplasty, primary; complete, external parts including bony pyramid, lateral and alar cartilages, and/or elevation of nasal tip |  |
`http://www.ama-assn.org/go/cpt` | 30420 | Rhinoplasty, primary; including major septal repair |  |
`http://www.ama-assn.org/go/cpt` | 30430 | Rhinoplasty, secondary; minor revision (small amount of nasal tip work) |  |
`http://www.ama-assn.org/go/cpt` | 30435 | Rhinoplasty, secondary; intermediate revision (bony work with osteotomies) |  |
`http://www.ama-assn.org/go/cpt` | 30450 | Rhinoplasty, secondary; major revision (nasal tip work and osteotomies) |  |
`http://www.ama-assn.org/go/cpt` | 31580 | Laryngoplasty; for laryngeal web, with indwelling keel or stent insertion |  |
`http://www.ama-assn.org/go/cpt` | 31587 | Laryngoplasty, cricoid split, without graft placement |  |
`http://www.ama-assn.org/go/cpt` | 31599 | Unlisted procedure, larynx |  |
`http://www.ama-assn.org/go/cpt` | 31899 | Unlisted procedure, trachea, bronchi |  |
`http://www.ama-assn.org/go/cpt` | 44145 | Colectomy, partial; with coloproctostomy (low pelvic anastomosis) |  |
`http://www.ama-assn.org/go/cpt` | 53400 | Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type) |  |
`http://www.ama-assn.org/go/cpt` | 53405 | Urethroplasty; second stage (formation of urethra), including urinary diversion |  |
`http://www.ama-assn.org/go/cpt` | 53410 | Urethroplasty, 1-stage reconstruction of male anterior urethra |  |
`http://www.ama-assn.org/go/cpt` | 53415 | Urethroplasty, transpubic or perineal, 1-stage, for reconstruction or repair of prostatic or membranous urethra |  |
`http://www.ama-assn.org/go/cpt` | 53420 | Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; first stage |  |
`http://www.ama-assn.org/go/cpt` | 53425 | Urethroplasty, 2-stage reconstruction or repair of prostatic or membranous urethra; second stage |  |
`http://www.ama-assn.org/go/cpt` | 53430 | Urethroplasty, reconstruction of female urethra |  |
`http://www.ama-assn.org/go/cpt` | 53460 | Urethromeatoplasty, with partial excision of distal urethral segment (Richardson type procedure) |  |
`http://www.ama-assn.org/go/cpt` | 54125 | Amputation of penis; complete |  |
`http://www.ama-assn.org/go/cpt` | 54340 | Repair of hypospadias complication(s) (ie, fistula, stricture, diverticula); by closure, incision, or excision, simple |  |
`http://www.ama-assn.org/go/cpt` | 54400 | Insertion of penile prosthesis; non-inflatable (semi-rigid) |  |
`http://www.ama-assn.org/go/cpt` | 54401 | Insertion of penile prosthesis; inflatable (self-contained) |  |
`http://www.ama-assn.org/go/cpt` | 54405 | Insertion of multi-component, inflatable penile prosthesis, including placement of pump, cylinders, and reservoir |  |
`http://www.ama-assn.org/go/cpt` | 54406 | Removal of all components of a multi-component, inflatable penile prosthesis without replacement of prosthesis |  |
`http://www.ama-assn.org/go/cpt` | 54408 | Repair of component(s) of a multi-component, inflatable penile prosthesis |  |
`http://www.ama-assn.org/go/cpt` | 54410 | Removal and replacement of all component(s) of a multi-component, inflatable penile prosthesis at the same operative session |  |
`http://www.ama-assn.org/go/cpt` | 54411 | Removal and replacement of all components of a multi-component inflatable penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue |  |
`http://www.ama-assn.org/go/cpt` | 54415 | Removal of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis, without replacement of prosthesis |  |
`http://www.ama-assn.org/go/cpt` | 54416 | Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis at the same operative session |  |
`http://www.ama-assn.org/go/cpt` | 54417 | Removal and replacement of non-inflatable (semi-rigid) or inflatable (self-contained) penile prosthesis through an infected field at the same operative session, including irrigation and debridement of infected tissue |  |
`http://www.ama-assn.org/go/cpt` | 54520 | Orchiectomy, simple (including subcapsular), with or without testicular prosthesis, scrotal or inguinal approach |  |
`http://www.ama-assn.org/go/cpt` | 54660 | Insertion of testicular prosthesis (separate procedure) |  |
`http://www.ama-assn.org/go/cpt` | 54690 | Laparoscopy, surgical; orchiectomy |  |
`http://www.ama-assn.org/go/cpt` | 55175 | Scrotoplasty; simple |  |
`http://www.ama-assn.org/go/cpt` | 55180 | Scrotoplasty; complicated |  |
`http://www.ama-assn.org/go/cpt` | 55970 | Intersex surgery; male to female |  |
`http://www.ama-assn.org/go/cpt` | 55980 | Intersex surgery; female to male |  |
`http://www.ama-assn.org/go/cpt` | 56625 | Vulvectomy simple; complete |  |
`http://www.ama-assn.org/go/cpt` | 56800 | Plastic repair of introitus |  |
`http://www.ama-assn.org/go/cpt` | 56805 | Clitoroplasty for intersex state |  |
`http://www.ama-assn.org/go/cpt` | 56810 | Perineoplasty, repair of perineum, nonobstetrical (separate procedure) |  |
`http://www.ama-assn.org/go/cpt` | 57106 | Vaginectomy, partial removal of vaginal wall; |  |
`http://www.ama-assn.org/go/cpt` | 57107 | Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) |  |
`http://www.ama-assn.org/go/cpt` | 57110 | Vaginectomy, complete removal of vaginal wall; |  |
`http://www.ama-assn.org/go/cpt` | 57111 | Vaginectomy, complete removal of vaginal wall; with removal of paravaginal tissue (radical vaginectomy) |  |
`http://www.ama-assn.org/go/cpt` | 57291 | Construction of artificial vagina; without graft |  |
`http://www.ama-assn.org/go/cpt` | 57292 | Construction of artificial vagina; with graft |  |
`http://www.ama-assn.org/go/cpt` | 57295 | Revision (including removal) of prosthetic vaginal graft; vaginal approach |  |
`http://www.ama-assn.org/go/cpt` | 57296 | Revision (including removal) of prosthetic vaginal graft; open abdominal approach |  |
`http://www.ama-assn.org/go/cpt` | 57335 | Vaginoplasty for intersex state |  |
`http://www.ama-assn.org/go/cpt` | 57426 | Revision (including removal) of prosthetic vaginal graft, laparoscopic approach |  |
`http://www.ama-assn.org/go/cpt` | 58150 | Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); |  |
`http://www.ama-assn.org/go/cpt` | 58180 | Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s) |  |
`http://www.ama-assn.org/go/cpt` | 58260 | Vaginal hysterectomy, for uterus 250 g or less; |  |
`http://www.ama-assn.org/go/cpt` | 58262 | Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) |  |
`http://www.ama-assn.org/go/cpt` | 58263 | Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele |  |
`http://www.ama-assn.org/go/cpt` | 58267 | Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control |  |
`http://www.ama-assn.org/go/cpt` | 58270 | Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele |  |
`http://www.ama-assn.org/go/cpt` | 58275 | Vaginal hysterectomy, with total or partial vaginectomy; |  |
`http://www.ama-assn.org/go/cpt` | 58280 | Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele |  |
`http://www.ama-assn.org/go/cpt` | 58285 | Vaginal hysterectomy, radical (Schauta type operation) |  |

Explanation of the columns that may appear on this page:

Level | A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System | The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code | The code (used as the code in the resource instance)
Display | The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition | An explanation of the meaning of the concept
Comments | Additional notes about how to use the code