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ICD-10-PCS 2027 procedure code

00XR4ZSTransfer Accessory Nerve to Hypoglossal Nerve, Percutaneous Endoscopic Approach

✓ Valid for 2027O.R. procedure

Short description: Transfer Accessory Nrv to Hypogloss Nrv, Perc Endo Approach

Code unchanged since ICD-10-PCS took effect on October 1, 2015. Source: official FY2027 ICD-10-PCS release from CMS. Page updated September 29, 2026. About our data

About 00XR4ZS

00XR4ZS is the ICD-10-PCS code for a transfer procedure on the accessory nerve using a percutaneous endoscopic approach (qualifier: hypoglossal nerve). In ICD-10-PCS, transfer means moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part.

In plain terms, this corresponds to transposition of cranial and peripheral nerves and Accessory-hypoglossal anastomosis, the ICD-9-CM procedure titles it maps to (04.6 and 04.73).

For a different body part, codes include 00XF4ZS (olfactory nerve), 00XG4ZS (optic nerve), 00XH4ZS (oculomotor nerve), 00XJ4ZS (trochlear nerve), 00XK4ZS (trigeminal nerve), 00XL4ZS (abducens nerve) and 5 more.

The same procedure with a different approach is coded 00XR0ZS (open).

It is an operating-room procedure in the MS-DRG logic for DRG 040 (Peripheral, Cranial Nerve and Other Nervous System Procedures with MCC), DRG 041 (Peripheral, Cranial Nerve and Other Nervous System Procedures with CC or Peripheral Neurostimulator), DRG 042 (Peripheral, Cranial Nerve and Other Nervous System Procedures without CC/MCC), DRG 143 (Other Ear, Nose, Mouth and Throat O.R. Procedures with MCC), DRG 144 (Other Ear, Nose, Mouth and Throat O.R. Procedures with CC) and DRG 145 (Other Ear, Nose, Mouth and Throat O.R. Procedures without CC/MCC), under the surgical categories “Peripheral, Cranial Nerve and Other Nervous System Procedures”, “Other Ear, Nose, Mouth and Throat O.R. Procedures”, “Other O.R. Procedures for Injuries” and 1 more.

It has been valid since ICD-10-PCS took effect on October 1, 2015.

What each character means

1. Section
0Medical and Surgical
2. Body System
0Central Nervous System and Cranial Nerves
3. Operation
XTransfer

Moving, without taking out, all or a portion of a body part to another location to take over the function of all or a portion of a body part

The body part transferred remains connected to its vascular and nervous supply

Includes: Tendon transfer, skin pedicle flap transfer

4. Body Part
RAccessory Nerve

Includes: Eleventh cranial nerve

5. Approach
4Percutaneous Endoscopic

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

6. Device
ZNo Device
7. Qualifier
SHypoglossal Nerve

Other versions of this procedure

Different approach

MS-DRG v44.0 grouping

All DRGs →

Surgical MS-DRGs this procedure can group to, depending on the principal diagnosis's MDC.

ICD-9-CM equivalent

Converter →
  • 04.6Transposition of cranial and peripheral nervesapproximate
  • 04.73Accessory-hypoglossal anastomosisapproximate

From the CMS 2018 General Equivalence Mappings (GEMs), the final GEMs release.

Code history

  1. 2016
  2. 2017
  3. 2018
  4. 2019
  5. 2020
  6. 2021
  7. 2022
  8. 2023
  9. 2024
  10. 2025
  11. 2026
  12. 2027
  • FY2016 (effective 10/1/2015): Added (first year of ICD-10-CM)
  • No changes since FY2016.

Common questions about 00XR4ZS

Is 00XR4ZS a valid ICD-10-PCS code for 2027?

Yes. 00XR4ZS is valid for inpatient procedures from October 1, 2026 through September 30, 2027.

Is 00XR4ZS an O.R. procedure?

Yes. 00XR4ZS is an O.R. procedure in MS-DRG v44.0.

What DRG does 00XR4ZS group to?

Depending on the principal diagnosis, 00XR4ZS can group to MS-DRG 040, MS-DRG 041, MS-DRG 042, MS-DRG 143, MS-DRG 144 and MS-DRG 145.

What is the ICD-9 procedure code for 00XR4ZS?

The CMS GEMs map 00XR4ZS to ICD-9-CM 04.6 (Transposition of cranial and peripheral nerves) and 04.73 (Accessory-hypoglossal anastomosis).