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ICD-10-PCS/0NP/0NP0X4Z
Inpatient Procedure Code

0NP0X4Z

Removal of Internal Fixation Device from Skull, External Approach

Removal of Int Fix from Skull, Extern Approach

Axis Breakdown

Every ICD-10-PCS code is exactly seven characters, one per axis. Each character's meaning is defined by its position in the code.

PositionValueMeaning
1
Section0

Medical and Surgical

2
Body SystemN

Head and Facial Bones

3
Root OperationP

Removal

Taking out or off a device from a body part

4
Body Part0

Skull

5
ApproachX

External

6
Device4

Internal Fixation Device

7
QualifierZ

No Qualifier

Potential MS-DRG Relationships (FY2026)

The MS-DRG grouper treats this as an operating room procedure. It appears in the surgical logic of 5 MS-DRGs:

  • MDC 01 — Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis: DRG 023, DRG 024
  • MDC 01 — Craniotomy and endovascular intracranial procedures: DRG 025, DRG 026, DRG 027

From the CMS MS-DRG Definitions Manual, Appendix E. Actual DRG assignment depends on the complete claim.

Contextual Map

Every relationship of 0NP0X4Z in one view: hierarchy, official tabular instructions in both directions, clinical classification, risk adjustment, MS-DRG participation, index terms and change history — each edge carrying the CMS source it derives from.

PCS table

  • 0NP[PCS table]
  • [object Object] — Section: [object Object] [Section]: “[object Object]”
  • [object Object] — Body System: [object Object] [Body System]: “[object Object]”
  • [object Object] — Operation: [object Object] [Operation]: “[object Object]”

MS-DRG participation

  • DRG 023 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR [MS-DRG]: “CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR — Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis (MDC 01)”
  • DRG 024 — CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC [MS-DRG]: “CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC — Craniotomy with Major Device Implant or Acute Complex CNS Principal Diagnosis (MDC 01)”
  • DRG 025 — CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC [MS-DRG]: “CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC — Craniotomy and endovascular intracranial procedures (MDC 01)”
  • DRG 026 — CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC [MS-DRG]: “CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC — Craniotomy and endovascular intracranial procedures (MDC 01)”
  • DRG 027 — CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC [MS-DRG]: “CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC — Craniotomy and endovascular intracranial procedures (MDC 01)”

Nearest codes

  • 0NP004Z — Removal of Internal Fixation Device from Skull, Open Approach [One axis away]
  • 0NP034Z — Removal of Internal Fixation Device from Skull, Percutaneous Approach [One axis away]
  • 0NP044Z — Removal of Internal Fixation Device from Skull, Percutaneous Endoscopic Approach [One axis away]
  • 0NP0X0Z — Removal of Drainage Device from Skull, External Approach [One axis away]
  • 0NP0X3Z — Removal of Infusion Device from Skull, External Approach [One axis away]
  • 0NP0X5Z — Removal of External Fixation Device from Skull, External Approach [One axis away]
  • 0NP0XMZ — Removal of Bone Growth Stimulator from Skull, External Approach [One axis away]
  • 0NP0XSZ — Removal of Hearing Device from Skull, External Approach [One axis away]

Change history

No changes recorded for this code — unchanged since the FY2026 (April) baseline of the change ledger.