Surgery

Document Title Document Type Document Size Effective Date
Ablative Treatment for Malignant Breast Tumor - (0540)  PDF 256kB 03/15/2023
Angioplasty (Extracranial, Intracranial) and Intracranial Aneurysm Repair - (0545)  PDF 363kB 11/15/2023
Balloon Sinus Ostial Dilation for Chronic Sinusitis and Eustachian Tube Dilation - (0480)  PDF 369kB 04/15/2023
Bariatric Surgery and Procedures - (0051)  PDF 1299kB 07/15/2023
Benign Prostatic Hyperplasia (BPH) Treatments - (0159)  PDF 515kB 10/15/2023
Blepharoplasty, Reconstructive Eyelid Surgery, and Brow Lift - (0045)  PDF 301kB 04/15/2023
Bone Graft Substitutes - (0118)  PDF 403kB 03/15/2023
Breast Implant Removal - (0048)  PDF 285kB 01/15/2023
Breast Reconstruction Following Mastectomy or Lumpectomy - (0178)  PDF 604kB 03/15/2023
Breast Reduction - (0152)  PDF 260kB 08/15/2023
Cardiac Resynchronization Therapy (CRT) and Advanced Cardiac Pacing Technologies - (0174)  PDF 640kB 12/15/2022
Cell-Based Therapy for Cardiac and Peripheral Arterial Disease - (0287)  PDF 444kB 04/15/2023
Cervical Fusion - (0527)  PDF 353kB 06/15/2023
Cochlear and Auditory Brainstem Implants - (0190)  PDF 453kB 11/15/2023
Corneal Remodeling for Refractive Errors - (0141)  PDF 412kB 10/15/2023
Deep Brain, Motor Cortex and Responsive Cortical Stimulation - (0184)  PDF 517kB 11/15/2022
Diagnostic Nasal/Sinus Endoscopy, Functional Endoscopic Sinus Surgery (FESS) and Turbinectomy - (0554)  PDF 562kB 10/15/2023
Diaphragmatic/Phrenic Nerve Stimulation - (0391)  PDF 360kB 09/15/2023
Discography - (0393)  PDF 267kB 11/15/2023
Distraction Osteogenesis (DO) for Craniofacial Deformities - (0407)  PDF 225kB 09/15/2023
Drug-Eluting Devices for Use Following Endoscopic Sinus Surgery - (0481)  PDF 408kB 04/15/2023
Extracorporeal Shock Wave Therapy (ESWT) for Musculoskeletal Conditions and Soft Tissue Wounds - (0004)  PDF 538kB 11/15/2023
Gastric Pacing/Gastric Electrical Stimulation (GES) - (0103)  PDF 281kB 11/15/2023
Gender Dysphoria Treatment - (0266)  PDF 366kB 08/15/2023
Gender Dysphoria Treatment - State Guidelines  PDF 157kB 10/23/2023
Glaucoma Surgical Procedures - (0035)  PDF 562kB 06/15/2023
Gynecomastia Surgery - (0195)  PDF 191kB 11/15/2023
Headache, Occipital, and/or Trigeminal Neuralgia Treatment - (0063)  PDF 477kB 06/15/2023
Implantable Cardioverter Defibrillator (ICD) - (0181)  PDF 562kB 10/15/2023
Interspinous Process Spacer Devices - (0448)  PDF 346kB 04/15/2023
Intraocular Lens Implant - (0125)  PDF 218kB 11/12/2023
Intraoperative Monitoring - (0509)  PDF 633kB 10/15/2023
Laser Interstitial Thermal Therapy - (0528)  PDF 325kB 08/15/2023
Lymphedema and Lipedema Surgical Treatments - (0531)  PDF 497kB 10/15/2023
Male Sexual Dysfunction Treatment: Non-pharmacologic - (0403)  PDF 504kB 08/15/2023
Mammary Ductoscopy, Aspiration and Lavage - (0057)  PDF 312kB 01/15/2023
Manipulation Under Anesthesia - (0276)  PDF 259kB 10/15/2023
Metatarsophalangeal Joint Replacement - (0446)  PDF 305kB 09/15/2023
Orthognathic Surgery - (0209)  PDF 269kB 10/15/2023
Otoplasty and External Ear Reconstruction - (0335)  PDF 249kB 04/15/2023
Panniculectomy and Abdominoplasty - (0027)  PDF 224kB 03/15/2023
Pelvic Denervation Procedures - (0368)  PDF 242kB 06/15/2023
Percutaneous Revascularization of the Lower Extremities in Adults - (0537)  PDF 438kB 02/15/2023
Percutaneous Vertebroplasty, Kyphoplasty and Sacroplasty - (0040)  PDF 442kB 08/15/2023
Peripheral Nerve Destruction for Pain Conditions - (0525)  PDF 565kB 12/03/2023
Redundant Skin Surgery - (0470)  PDF 219kB 06/15/2023
Rhinoplasty, Vestibular Stenosis Repair and Septoplasty - (0119)  PDF 402kB 11/12/2023
Stem Cell Therapy for Orthopaedic Applications - (0552)  PDF 344kB 03/15/2023
Subtalar Joint Implantation (Subtalar Arthroereisis) - (0486)  PDF 217kB 10/15/2023
Surgical Treatment for Chest Wall Deformities - (0309)  PDF 263kB 07/15/2023
Surgical Treatment for Hyperhidrosis - (0037)  PDF 253kB 01/15/2023
Surgical Treatments for Obstructive Sleep Apnea - (0158)  PDF 383kB 10/15/2023
Temporomandibular Joint (TMJ) Disorder Surgery - (0156)  PDF 288kB 12/15/2022
Thermal Shrinkage - (0176)  PDF 231kB 07/15/2023
Thymus Tissue Transplantation - (0561)  PDF 192kB 08/15/2023
Transcatheter Ablation for the Treatment of Supraventricular Tachycardia in Adults - (0529)  PDF 331kB 04/15/2023
Transcatheter Closure of Cardiovascular Defects - (0011)  PDF 372kB 11/15/2023
Transcatheter Heart Valve Procedures - (0501)  PDF 913kB 12/03/2023
Transcranial Magnetic Stimulation - (EN0383)  PDF 594kB 08/23/2023
Treatment of Cutaneous and/or Deep Tissue Hemangioma, Port Wine Stain and Other Vascular Lesions - (0313)  PDF 331kB 05/15/2023
Vagus Nerve Stimulation (VNS) - (0350)  PDF 414kB 12/15/2022
Varicose Vein Treatments - (0234)  PDF 660kB 11/15/2023
Venous Angioplasty and/or Stent Placement in Adults - (0541)  PDF 499kB 06/15/2023
Ventricular Assist Devices (VADs), Percutaneous Cardiac Support Systems and Total Artificial Heart - (0054)  PDF 650kB 12/15/2022