Code of Colorado Regulations
1100 - Department of Labor and Employment
1101 - Division of Workers' Compensation
7 CCR 1101-3 R18 Exhibits - Rule 18, Exhibits
Exhibit #4 - Effective 1/1/2024 APCs for Procedures with Status Indicator C When Performed in an OP Hospital or ASC
|
Proc |
Description |
APC |
|
0202T |
Post vert arthrplst 1 lumbar |
5115 |
|
0219T |
Plmt post facet implt cerv |
5115 |
|
0220T |
Plmt post facet implt thor |
5115 |
|
20802 |
Replantation arm complete |
5116 |
|
20805 |
Replant forearm complete |
5116 |
|
20808 |
Replantation hand complete |
5116 |
|
20816 |
Replantation digit complete |
5114 |
|
20824 |
Replantation thumb complete |
5114 |
|
20827 |
Replantation thumb complete |
5114 |
|
20838 |
Replantation foot complete |
5116 |
|
20955 |
Fibula bone graft microvasc |
5114 |
|
20956 |
Iliac bone graft microvasc |
5114 |
|
20957 |
Mt bone graft microvasc |
5114 |
|
20962 |
Other bone graft microvasc |
5114 |
|
20969 |
Bone/skin graft microvasc |
5114 |
|
20970 |
Bone/skin graft iliac crest |
5114 |
|
21045 |
Extensive jaw surgery |
5165 |
|
21145 |
Lefort i-1 piece w/ graft |
5165 |
|
21146 |
Lefort i-2 piece w/ graft |
5165 |
|
21147 |
Lefort i-3/> piece w/ graft |
5165 |
|
21151 |
Lefort ii w/bone grafts |
5165 |
|
21154 |
Lefort iii w/o lefort i |
5165 |
|
21155 |
Lefort iii w/ lefort i |
5165 |
|
21159 |
Lefort iii w/fhdw/o lefort i |
5165 |
|
21160 |
Lefort iii w/fhd w/ lefort i |
5165 |
|
21179 |
Reconstruct entire forehead |
5165 |
|
21180 |
Reconstruct entire forehead |
5165 |
|
21182 |
Reconstruct cranial bone |
5165 |
|
21183 |
Reconstruct cranial bone |
5165 |
|
21184 |
Reconstruct cranial bone |
5165 |
|
21188 |
Reconstruction of midface |
5165 |
|
21247 |
Reconstruct lower jaw bone |
5165 |
|
21268 |
Revise eye sockets |
5165 |
|
21343 |
Open tx dprsd front sinus fx |
5165 |
|
21344 |
Open tx compl front sinus fx |
5165 |
|
21348 |
Opn tx nasomax fx w/graft |
5165 |
|
21423 |
Treat mouth roof fracture |
5165 |
|
21431 |
Treat craniofacial fracture |
5165 |
|
21432 |
Treat craniofacial fracture |
5165 |
|
21433 |
Treat craniofacial fracture |
5165 |
|
21435 |
Treat craniofacial fracture |
5165 |
|
21436 |
Treat craniofacial fracture |
5165 |
|
21510 |
Drainage of bone lesion |
5114 |
|
21602 |
Exc ch wal tum w/o lymphadec |
5114 |
|
21603 |
Exc ch wal tum w/lymphadec |
5114 |
|
21615 |
Removal of rib |
5114 |
|
21616 |
Removal of rib and nerves |
5114 |
|
21620 |
Partial removal of sternum |
5114 |
|
21627 |
Sternal debridement |
5114 |
|
21630 |
Extensive sternum surgery |
5114 |
|
21632 |
Extensive sternum surgery |
5114 |
|
21705 |
Revision of neck muscle/rib |
5114 |
|
21740 |
Reconstruction of sternum |
5114 |
|
21750 |
Repair of sternum separation |
5114 |
|
21825 |
Treat sternum fracture |
5114 |
|
22010 |
I&d p-spine c/t/cerv-thor |
5114 |
|
22015 |
I&d abscess p-spine l/s/ls |
5114 |
|
22110 |
Remove part of neck vertebra |
5114 |
|
22112 |
Remove part thorax vertebra |
5114 |
|
22114 |
Remove part lumbar vertebra |
5114 |
|
22206 |
Incis spine 3 column thorac |
5114 |
|
22207 |
Incis spine 3 column lumbar |
5114 |
|
22210 |
Incis 1 vertebral seg cerv |
5114 |
|
22212 |
Incis 1 vertebral seg thorac |
5114 |
|
22214 |
Incis 1 vertebral seg lumbar |
5114 |
|
22220 |
Osteot dsc ant 1 vrt sgm crv |
5114 |
|
22222 |
Osteot dsc ant 1vrt sgm thrc |
5114 |
|
22224 |
Osteot dsc ant 1vrt sgm lmbr |
5114 |
|
22318 |
Treat odontoid fx w/o graft |
5115 |
|
22319 |
Treat odontoid fx w/graft |
5115 |
|
22325 |
Treat spine fracture |
5115 |
|
22326 |
Treat neck spine fracture |
5115 |
|
22327 |
Treat thorax spine fracture |
5115 |
|
22532 |
Arthrd lat xtrcvtry tq thrc |
5116 |
|
22533 |
Arthrd lat xtrcvtry tq lmbr |
5116 |
|
22548 |
Arthrd ant toral/xoral c1-c2 |
5116 |
|
22556 |
Arthrd ant ntrbd min dsc thc |
5116 |
|
22558 |
Arthrd ant ntrbd min dsc lum |
5116 |
|
22586 |
Arthrd pre-sac ntrbdy l5-s1 |
5116 |
|
22590 |
Arthrd pst tq craniocervical |
5116 |
|
22595 |
Arthrd pst tq atlas-axis |
5116 |
|
22600 |
Arthrd pst tq 1ntrspc crv |
5116 |
|
22610 |
Arthrd pst tq 1ntrspc thrc |
5116 |
|
22800 |
Arthrd pst dfrm< vrt sgm |
5116 |
|
22802 |
Arthrd pst dfrm 7-12 vrt sgm |
5116 |
|
22804 |
Arthrd pst dfrm 13+ vrt sgm |
5116 |
|
22808 |
Arthrd ant dfrm 2-3 vrt sgm |
5116 |
|
22810 |
Arthrd ant dfrm 4-7 vrt sgm |
5116 |
|
22812 |
Arthrd ant dfrm 8+ vrt sgm |
5116 |
|
22818 |
Kyphectomy 1-2 segments |
5116 |
|
22819 |
Kyphectomy 3 or more |
5116 |
|
22830 |
Exploration of spinal fusion |
5115 |
|
22849 |
Reinsert spinal fixation |
5116 |
|
22850 |
Remove spine fixation device |
5115 |
|
22852 |
Remove spine fixation device |
5115 |
|
22855 |
Remove spine fixation device |
5115 |
|
22857 |
Tot disc arthrp ant lumbar |
5116 |
|
22861 |
Revise cerv artific disc |
5116 |
|
22862 |
Revise lumbar artif disc |
5116 |
|
22864 |
Remove cerv artif disc |
5115 |
|
22865 |
Remove lumb artif disc |
5115 |
|
23200 |
Resect clavicle tumor |
5114 |
|
23210 |
Resect scapula tumor |
5114 |
|
23220 |
Resect prox humerus tumor |
5114 |
|
23335 |
Shoulder prosthesis removal |
5073 |
|
23474 |
Revis reconst shoulder joint |
5115 |
|
23900 |
Amputation of arm & girdle |
5115 |
|
23920 |
Amputation at shoulder joint |
5115 |
|
24900 |
Amputation of upper arm |
5115 |
|
24920 |
Amputation of upper arm |
5115 |
|
24930 |
Amputation follow-up surgery |
5114 |
|
24931 |
Amputate upper arm & implant |
5115 |
|
24940 |
Revision of upper arm |
5115 |
|
25900 |
Amputation of forearm |
5115 |
|
25905 |
Amputation of forearm |
5115 |
|
25915 |
Amputation of forearm |
5114 |
|
25920 |
Amputate hand at wrist |
5114 |
|
25924 |
Amputation follow-up surgery |
5114 |
|
25927 |
Amputation of hand |
5113 |
|
26551 |
Great toe-hand transfer |
5114 |
|
26553 |
Single transfer toe-hand |
5114 |
|
26554 |
Double transfer toe-hand |
5114 |
|
26556 |
Toe joint transfer |
5114 |
|
26992 |
Drainage of bone lesion |
5114 |
|
27005 |
Incision of hip tendon |
5114 |
|
27025 |
Incision of hip/thigh fascia |
5114 |
|
27030 |
Drainage of hip joint |
5114 |
|
27036 |
Excision of iiip joint/muscle |
5114 |
|
27054 |
Removal of iiip joint lining |
5113 |
|
27070 |
Part remove hip bone super |
5114 |
|
27071 |
Part removal hip bone deep |
5114 |
|
27075 |
Resect hip tumor |
5114 |
|
27076 |
Resect hip tum inci acetabul |
5114 |
|
27077 |
Resect hip tum w/innom bone |
5115 |
|
27078 |
Rsect hip tum incI femur |
5115 |
|
27090 |
Removal of hip prosthesis |
5073 |
|
27091 |
Removal of hip prosthesis |
5073 |
|
27120 |
Reconstruction of hip socket |
5115 |
|
27122 |
Reconstruction of hip socket |
5115 |
|
27125 |
Partial hip replacement |
5115 |
|
27132 |
Total hip arthroplasty |
5115 |
|
27134 |
Revise hip joint replacement |
5115 |
|
27137 |
Revise hip joint replacement |
5115 |
|
27138 |
Revise hip joint replacement |
5115 |
|
27140 |
Transplant femur ridge |
5115 |
|
27146 |
Incision of hip bone |
5114 |
|
27147 |
Revision of hip bone |
5114 |
|
27151 |
Incision of hip bones |
5114 |
|
27156 |
Revision of hip bones |
5114 |
|
27158 |
Revision of pelvis |
5114 |
|
27161 |
Incision of neck of femur |
5114 |
|
27165 |
Incision/fixation of femur |
5114 |
|
27170 |
Repair/graft femur head/neck |
5114 |
|
27175 |
Treat slipped epiphysis |
5114 |
|
27176 |
Treat slipped epiphysis |
5115 |
|
27177 |
Treat slipped epiphysis |
5114 |
|
27178 |
Treat slipped epiphysis |
5114 |
|
27181 |
Treat slipped epiphysis |
5114 |
|
27185 |
Revision of femur epiphysis |
5114 |
|
27187 |
Reinforce hip bones |
5114 |
|
27226 |
Treat hip wall fracture |
5114 |
|
27227 |
Treat hip fracture(s) |
5114 |
|
27228 |
Treat hip fracture(s) |
5114 |
|
27232 |
Treat thigh fracture |
5112 |
|
27236 |
Treat thigh fracture |
5114 |
|
27240 |
Treat thigh fracture |
5112 |
|
27244 |
Treat thigh fracture |
5114 |
|
27245 |
Treat thigh fracture |
5114 |
|
27248 |
Treat thigh fracture |
5114 |
|
27253 |
Treat hip dislocation |
5113 |
|
27254 |
Treat hip dislocation |
5113 |
|
27258 |
Treat hip dislocation |
5113 |
|
27259 |
Treat hip dislocation |
5113 |
|
27268 |
Cltx thigh fx w/mnpj |
5113 |
|
27269 |
Optx thigh fx |
5112 |
|
27280 |
Fusion of sacroiliac joint |
5116 |
|
27282 |
Fusion of pubic bones |
5115 |
|
27284 |
Fusion of hip joint |
5116 |
|
27286 |
Fusion of hip joint |
5116 |
|
27290 |
Amputation of leg at hip |
5116 |
|
27295 |
Amputation of leg at hip |
5116 |
|
27303 |
Drainage of bone lesion |
5114 |
|
27365 |
Resect femur/knee tumor |
5114 |
|
27445 |
Revision of knee joint |
5115 |
|
27448 |
Incision of thigh |
5114 |
|
27450 |
Incision of thigh |
5114 |
|
27454 |
Realignment of thigh bone |
5114 |
|
27455 |
Realignment of knee |
5114 |
|
27457 |
Realignment of knee |
5114 |
|
27465 |
Shortening of thigh bone |
5114 |
|
27466 |
Lengthening of thigh bone |
5114 |
|
27468 |
Shorten/lengthen thighs |
5114 |
|
27470 |
Repair of thigh |
5114 |
|
27472 |
Repair/graft of thigh |
5114 |
|
27486 |
Revise/replace knee joint |
5115 |
|
27487 |
Revise/replace knee joint |
5115 |
|
27488 |
Removal of knee prosthesis |
5114 |
|
27495 |
Reinforce thigh |
5114 |
|
27506 |
Treatment of thigh fracture |
5114 |
|
27507 |
Treatment of thigh fracture |
5114 |
|
27511 |
Treatment of thigh fracture |
5114 |
|
27513 |
Treatment of thigh fracture |
5114 |
|
27514 |
Treatment of thigh fracture |
5114 |
|
27519 |
Treat thigh fx growth plate |
5114 |
|
27535 |
Treat knee fracture |
5114 |
|
27536 |
Treat knee fracture |
5114 |
|
27540 |
Treat knee fracture |
5114 |
|
27556 |
Treat knee dislocation |
5114 |
|
27557 |
Treat knee dislocation |
5114 |
|
27558 |
Treat knee dislocation |
5114 |
|
27580 |
Fusion of knee |
5115 |
|
27590 |
Amputate leg at thigh |
5116 |
|
27591 |
Amputate leg at thigh |
5116 |
|
27592 |
Amputate leg at thigh |
5116 |
|
27596 |
Amputation follow-up surgery |
5114 |
|
27598 |
Amputate lower leg at knee |
5115 |
|
27645 |
Resect tibia tumor |
5114 |
|
27646 |
Resect fibula tumor |
5114 |
|
27703 |
Reconstruction ankle joint |
5115 |
|
27712 |
Realignment of lower leg |
5115 |
|
27715 |
Revision of lower leg |
5115 |
|
27724 |
Repair/graft of tibia |
5114 |
|
27725 |
Repair of lower leg |
5114 |
|
27727 |
Repair of lower leg |
5114 |
|
27880 |
Amputation of lower leg |
5116 |
|
27881 |
Amputation of lower leg |
5114 |
|
27882 |
Amputation of lower leg |
5114 |
|
27886 |
Amputation follow-up surgery |
5114 |
|
27888 |
Amputation of foot at ankle |
5115 |
|
28800 |
Amputation of midfoot |
5113 |
|
35372 |
Rechanneling of artery |
5184 |
|
35800 |
Explore neck vessels |
5184 |
|
37182 |
Insert hepatic shunt (tips) |
5193 |
|
37617 |
Ligation of abdomen artery |
5183 |
|
38562 |
Removal pelvic lymph nodes |
5362 |
|
43840 |
Repair of stomach lesion |
5331 |
|
44300 |
Open bowel to skin |
5302 |
|
44345 |
Revision of colostomy |
5341 |
|
44346 |
Revision of colostomy |
5341 |
|
44602 |
Suture small intestine |
5303 |
|
49010 |
Exploration behind abdomen |
5341 |
|
49255 |
Removal of omentum |
5341 |
|
51840 |
Attach bladder/urethra |
5415 |
|
56630 |
Extensive vulva surgery |
5415 |
|
61624 |
Transcath occlusion ens |
5194 |
|
G0412 |
Open tx iliac spine uni/bil |
5114 |
|
G0414 |
Pelvic ring fx treat int fix |
5115 |
|
G0415 |
Open tx post pelvic ftccture |
5115 |
