ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview

The International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) code group X2RX includes procedures performed to replace portions of the thoracic aorta using branched synthetic substitutes and intraluminal devices in the aortic arch. These ICD-10-PCS codes are used for inpatient documentation when an open replacement of the thoracic aorta at the arch is performed with implantation of a branched synthetic substitute and an intraluminal device. Accurate coding within the ICD-10-PCS X2RX group is essential for proper inpatient reimbursement, as it captures the specific procedure performed and supports clinical documentation accuracy and appropriate payment.

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Thoracic Aorta, Arch Replacement Procedure Overview

Procedures in this group involve replacement of all or part of the thoracic aorta at the aortic arch using a branched synthetic substitute combined with an intraluminal device, performed through an open approach. These procedures target the cardiovascular system and restore or substitute the function of the diseased aortic arch. Accurate International Classification of Diseases, 10th Revision, Procedure Coding System coding is important for inpatient documentation and reimbursement because it captures the specific operation, materials used, and approach. Proper coding supports appropriate case mix assignment and payment for complex cardiovascular procedures.

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
X	Section	New Technology
2	Body System	Cardiovascular System
R	Operation	Replacement
X	Body Part	Thoracic Aorta, Arch

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ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview

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Thoracic Aorta, Arch Replacement Procedure Overview

Code Attributes

Character	ICD-10-PCS Category	Code Group Details
X	Section	New Technology
2	Body System	Cardiovascular System
R	Operation	Replacement
X	Body Part	Thoracic Aorta, Arch

When to Use

Use a code from this group when an open surgical replacement of the thoracic aorta involving the aortic arch is performed using a branched synthetic graft and an intraluminal device. Select the specific X2RX code that matches the New Technology group and documented materials, approach, and anatomic site.

ICD-10-PCS Codes

1 rows

ICD-10-PCS Code	Description
X2RX0N7	Replacement of Thoracic Aorta, Arch using Branched Synthetic Substitute with Intraluminal Device, Open Approach, New Technology Group 7

DRG Codes

17 rows

DRG Code	Description
163	Major Chest Procedures with MCC
164	Major Chest Procedures with CC
165	Major Chest Procedures without CC/MCC
209	Complex Aortic Arch Procedures
212	Concomitant Aortic and Mitral Valve Procedures
216	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC
217	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC
218	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC
219	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC
220	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC

Showing 1–10 of 17

Typical Clinical Scenarios

An elderly patient with a symptomatic, large saccular aneurysm of the aortic arch identified on CT angiography after progressive hoarseness and chest pain is admitted for urgent open surgical repair because the arch aneurysm risks rupture and involves the origins of the brachiocephalic vessels. The team plans replacement of the diseased arch segment with a branched synthetic graft and placement of an intraluminal device to reestablish flow to the head and upper extremities while excluding the aneurysm. Typical codes: X2RX0N7
A middle-aged patient with chronic connective tissue disease and a progressively enlarging fusiform aneurysm of the thoracic aortic arch is scheduled electively for open arch replacement to prevent future rupture; preoperative imaging shows involvement of the arch necessitating branch reconstruction. During the planned inpatient operation the surgeon replaces the arch with a branched synthetic substitute and deploys an intraluminal device to reconstruct the lumen and branch origins. Typical codes: X2RX0N7
A patient who previously underwent endovascular stent-grafting for an aortic arch aneurysm presents with endoleak and persistent sac expansion requiring conversion to an open procedure; intraoperatively the surgeon replaces the diseased arch segment using a branched synthetic graft with an intraluminal device to manage the failed endovascular repair. Typical codes: X2RX0N7

Related Codes

X2R5-RIGHT-UPPER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Right Upper Extremity: Procedure Code Group Overview

X2R6-LEFT-UPPER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Left Upper Extremity: Procedure Code Group Overview

X2R7-RIGHT-LOWER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Right Lower Extremity: Procedure Code Group Overview

X2R8-LEFT-LOWER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Left Lower Extremity: Procedure Code Group Overview

X2RJ-TRICUSPID-VALVE-REPLACEMENT

ICD-10-PCS Code For Tricuspid Valve: Procedure Code Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

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When to Use

ICD-10-PCS Codes

1 rows

ICD-10-PCS Code	Description
X2RX0N7	Replacement of Thoracic Aorta, Arch using Branched Synthetic Substitute with Intraluminal Device, Open Approach, New Technology Group 7

DRG Codes

17 rows

DRG Code	Description
163	Major Chest Procedures with MCC
164	Major Chest Procedures with CC
165	Major Chest Procedures without CC/MCC
209	Complex Aortic Arch Procedures
212	Concomitant Aortic and Mitral Valve Procedures
216	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with MCC
217	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization with CC
218	Cardiac Valve and Other Major Cardiothoracic Procedures with Cardiac Catheterization without CC/MCC
219	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with MCC
220	Cardiac Valve and Other Major Cardiothoracic Procedures without Cardiac Catheterization with CC

Showing 1–10 of 17

Typical Clinical Scenarios

An elderly patient with a symptomatic, large saccular aneurysm of the aortic arch identified on CT angiography after progressive hoarseness and chest pain is admitted for urgent open surgical repair because the arch aneurysm risks rupture and involves the origins of the brachiocephalic vessels. The team plans replacement of the diseased arch segment with a branched synthetic graft and placement of an intraluminal device to reestablish flow to the head and upper extremities while excluding the aneurysm. Typical codes: X2RX0N7
A middle-aged patient with chronic connective tissue disease and a progressively enlarging fusiform aneurysm of the thoracic aortic arch is scheduled electively for open arch replacement to prevent future rupture; preoperative imaging shows involvement of the arch necessitating branch reconstruction. During the planned inpatient operation the surgeon replaces the arch with a branched synthetic substitute and deploys an intraluminal device to reconstruct the lumen and branch origins. Typical codes: X2RX0N7
A patient who previously underwent endovascular stent-grafting for an aortic arch aneurysm presents with endoleak and persistent sac expansion requiring conversion to an open procedure; intraoperatively the surgeon replaces the diseased arch segment using a branched synthetic graft with an intraluminal device to manage the failed endovascular repair. Typical codes: X2RX0N7

Related Codes

X2R5-RIGHT-UPPER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Right Upper Extremity: Procedure Code Group Overview

X2R6-LEFT-UPPER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Left Upper Extremity: Procedure Code Group Overview

X2R7-RIGHT-LOWER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Right Lower Extremity: Procedure Code Group Overview

X2R8-LEFT-LOWER-EXTREMITY-REPLACEMENT

ICD-10-PCS Code For Left Lower Extremity: Procedure Code Group Overview

X2RJ-TRICUSPID-VALVE-REPLACEMENT

ICD-10-PCS Code For Tricuspid Valve: Procedure Code Group Overview

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview policy alerts

Thoracic Aorta, Arch Replacement Procedure Overview

Code Attributes

ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview

Sign up for ICD-10-PCS Code For Thoracic Aorta, Arch: Procedure Code Group Overview policy alerts

Thoracic Aorta, Arch Replacement Procedure Overview

Code Attributes

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS code represents replacement of the thoracic aorta at the arch using a branched synthetic substitute with an intraluminal device via open approach?

What procedural attributes identify codes in the X2RX group?

For which clinical setting are X2RX ICD-10-PCS codes intended to be used?

How does correct coding in the X2RX group affect reimbursement and case assignment?

Which DRGs may be related to procedures coded in the X2RX group?

References

When to Use

ICD-10-PCS Codes

DRG Codes

Typical Clinical Scenarios

Related Codes

Which ICD-10-PCS code represents replacement of the thoracic aorta at the arch using a branched synthetic substitute with an intraluminal device via open approach?

What procedural attributes identify codes in the X2RX group?

For which clinical setting are X2RX ICD-10-PCS codes intended to be used?

How does correct coding in the X2RX group affect reimbursement and case assignment?

Which DRGs may be related to procedures coded in the X2RX group?

References