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ICD 10 Code 04V54CZ

Restriction of Superior Mesenteric Artery with Extraluminal Device, Percutaneous Endoscopic Approach
“Restrict Sup Mesent Art w Extralum Dev, Perc Endo” for short

04V54CZ is a valid billable ICD-10 procedure code for Restriction of Superior Mesenteric Artery with Extraluminal Device, Percutaneous Endoscopic Approach. It is found in the 2025 version of the ICD-10 Procedure Coding System (PCS) and can be used in all HIPAA-covered transactions from Oct 01, 2024 - Sep 30, 2025.

Restriction involves:
Partially closing an orifice or the lumen of a tubular body part. The orifice can be a natural orifice or an artificially created orifice

Percutaneous Endoscopic approach involves:
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

Restriction includes:

  • Esophagogastric fundoplication, cervical cerclage

Superior Mesenteric Artery body part includes:

  • Ileal artery
  • Ileocolic artery
  • Inferior pancreaticoduodenal artery
  • Jejunal artery

Extraluminal Device device includes:

  • AtriClip LAA Exclusion System
  • LAP-BAND(R) adjustable gastric banding system
  • REALIZE(R) Adjustable Gastric Band
MS-DRG - Medicare Severity-Diagnosis Related Group
  • MDC 05 Diseases & Disorders of the Circulatory System
    Other Vascular Procedures
    • DRG 252 - OTHER VASCULAR PROCEDURES WITH MCC
    • DRG 253 - OTHER VASCULAR PROCEDURES WITH CC
    • DRG 254 - OTHER VASCULAR PROCEDURES WITHOUT CC/MCC

ICD-10-PCS code structure for 04V54CZ — See Table View

1: Section 0 Medical and Surgical
2: Body System 4 Lower Arteries
3: Root Operation V Restriction
4: Body Part 5 Superior Mesenteric Artery
5: Approach 4 Percutaneous Endoscopic
6: Device C Extraluminal Device
7: Qualifier Z No Qualifier

See also

  • The ICD-10-PCS Index of common procedure terms.
  • Medical and Surgical terms in the ICD-10-PCS Definitions table. These definitions may also provide additional explanation and/or examples within this section.
  • The ICD-10-PCS Device Aggregation Table containing entries that correlate a specific ICD-10-PCS device value with a general device value to be used in tables containing only general device values.