2025 ICD-10-PCS Procedure Code 021X49D

021X49D PCS Table

In an PCS table each code is represented by up seven alphanumeric characters, with each character in the table respresenting different aspects of the procedure. In the table provided below, each row represents an individual character and includes information about the character's position, designation, label, and procedure notes. For this PCS table the procedure code is in the medical and surgical section and is part of the heart and great vessels body system, classified under bypass operation. The applicable bodypart for this procedure code is thoracic aorta, ascending/arch.

Replacement Code

021X49D replaces the following previously assigned ICD-10-PCS code(s):

• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo
• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo
• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo
• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo
• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo
• 021W49D - Bypass Thor Aorta Desc to Carotid w Autol Vn, Perc Endo

Clinical Classification

MS-DRG Mapping for ICD-10-PCS Code 021X49D

ICD-10-PCS procedure codes are grouped into Medicare Severity Diagnosis Related Groups (MS-DRGs) to support consistent hospital reimbursement and care planning. MS-DRGs classify inpatient stays based on clinical similarity and expected resource use, using information such as the primary procedure, secondary diagnoses, and patient condition.

Each hospital stay is assigned a single DRG, which determines a fixed payment rate from Medicare. This rate accounts for the complexity of the procedure and the overall cost of care.

The code 021X49D maps to the following MS-DRGs in version V42.0, effective from October 1, 2024, through September 30, 2025. These groupings are key to understanding how the procedure impacts billing and hospital resource allocation.

Convert to ICD-9-PCS

Below are the ICD-9=PCS code(s) that most closely match this ICD-10-PCS code, based on the General Equivalence Mappings (GEMs). This ICD-10-PCS to ICD-9-PCS crosswalk tool is helpful for coders who need to reference legacy diagnosis codes for audits, historical claims, or approximate code comparisons.

Other ICD-10-PCS Codes Used for Bypass Thoracic Aorta, Ascending/Arch

Filter related codes list:

• 021X08A Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Zooplastic Tissue, Open Approach

• 021X08B Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Zooplastic Tissue, Open Approach

• 021X08D Bypass Thoracic Aorta, Ascending/Arch to Carotid with Zooplastic Tissue, Open Approach

• 021X08P Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Zooplastic Tissue, Open Approach

• 021X08Q Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Zooplastic Tissue, Open Approach

• 021X08R Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Zooplastic Tissue, Open Approach

• 021X09A Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Autologous Venous Tissue, Open Approach

• 021X09B Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Autologous Venous Tissue, Open Approach

• 021X09D Bypass Thoracic Aorta, Ascending/Arch to Carotid with Autologous Venous Tissue, Open Approach

• 021X09P Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Autologous Venous Tissue, Open Approach

• 021X09Q Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Autologous Venous Tissue, Open Approach

• 021X09R Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Autologous Venous Tissue, Open Approach

• 021X0AA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Autologous Arterial Tissue, Open Approach

• 021X0AB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Autologous Arterial Tissue, Open Approach

• 021X0AD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Autologous Arterial Tissue, Open Approach

• 021X0AP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Autologous Arterial Tissue, Open Approach

• 021X0AQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Autologous Arterial Tissue, Open Approach

• 021X0AR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Autologous Arterial Tissue, Open Approach

• 021X0JA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Synthetic Substitute, Open Approach

• 021X0JB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Synthetic Substitute, Open Approach

• 021X0JD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Synthetic Substitute, Open Approach

• 021X0JP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Synthetic Substitute, Open Approach

• 021X0JQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Synthetic Substitute, Open Approach

• 021X0JR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Synthetic Substitute, Open Approach

• 021X0KA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Nonautologous Tissue Substitute, Open Approach

• 021X0KB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Nonautologous Tissue Substitute, Open Approach

• 021X0KD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Nonautologous Tissue Substitute, Open Approach

• 021X0KP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Nonautologous Tissue Substitute, Open Approach

• 021X0KQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Nonautologous Tissue Substitute, Open Approach

• 021X0KR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Nonautologous Tissue Substitute, Open Approach

• 021X0ZA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery, Open Approach

• 021X0ZB Bypass Thoracic Aorta, Ascending/Arch to Subclavian, Open Approach

• 021X0ZD Bypass Thoracic Aorta, Ascending/Arch to Carotid, Open Approach

• 021X0ZP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk, Open Approach

• 021X0ZQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery, Open Approach

• 021X0ZR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery, Open Approach

• 021X48A Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X48B Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X48D Bypass Thoracic Aorta, Ascending/Arch to Carotid with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X48P Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X48Q Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X48R Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Zooplastic Tissue, Percutaneous Endoscopic Approach

• 021X49A Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

• 021X49B Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Autologous Venous Tissue, Percutaneous Endoscopic Approach

• 021X49P Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Autologous Venous Tissue, Percutaneous Endoscopic Approach

• 021X49Q Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

• 021X49R Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Autologous Venous Tissue, Percutaneous Endoscopic Approach

• 021X4AA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4AB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4AD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4AP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4AQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4AR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Autologous Arterial Tissue, Percutaneous Endoscopic Approach

• 021X4JA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4JB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4JD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4JP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4JQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4JR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Synthetic Substitute, Percutaneous Endoscopic Approach

• 021X4KA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4KB Bypass Thoracic Aorta, Ascending/Arch to Subclavian with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4KD Bypass Thoracic Aorta, Ascending/Arch to Carotid with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4KP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4KQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4KR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery with Nonautologous Tissue Substitute, Percutaneous Endoscopic Approach

• 021X4ZA Bypass Thoracic Aorta, Ascending/Arch to Innominate Artery, Percutaneous Endoscopic Approach

• 021X4ZB Bypass Thoracic Aorta, Ascending/Arch to Subclavian, Percutaneous Endoscopic Approach

• 021X4ZD Bypass Thoracic Aorta, Ascending/Arch to Carotid, Percutaneous Endoscopic Approach

• 021X4ZP Bypass Thoracic Aorta, Ascending/Arch to Pulmonary Trunk, Percutaneous Endoscopic Approach

• 021X4ZQ Bypass Thoracic Aorta, Ascending/Arch to Right Pulmonary Artery, Percutaneous Endoscopic Approach

• 021X4ZR Bypass Thoracic Aorta, Ascending/Arch to Left Pulmonary Artery, Percutaneous Endoscopic Approach

What is ICD-10-PCS?

The ICD-10 Procedure Coding System (ICD-10-PCS) is a catalog of procedural codes used by medical professionals for hospital inpatient healthcare settings. The Centers for Medicare and Medicaid Services (CMS) maintain the catalog in the U.S. releasing yearly updates. The 2025 ICD-10-PCS codes are to be used for discharges occurring from October 1, 2024 through September 30, 2025.

Each ICD-10-PCS code has a structure of seven alphanumeric characters and contains no decimals. The first character defines the major "section". Depending on the "section" the second through seventh characters mean different things.