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ICD-10-PCS

Last updated: 05-21-2025
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What is ICD-10-PCS?​

ICD-10-PCS stands for International Classification of Diseases, 10th Revision, Procedure Coding System. It is the U.S. procedural coding system developed by the Centers for Medicare & Medicaid Services (CMS) for use in inpatient hospital settings.

  • Maintained by: Centers for Medicare & Medicaid Services (CMS)
  • Purpose: Enables standardized coding of medical procedures performed in inpatient facilities
  • Usage: Hospital billing, DRG assignment, reimbursement, clinical research, utilization review, and quality reporting

Who Maintains ICD-10-PCS?​

The ICD-10 Coordination and Maintenance Committee coordinates and maintains the ICD-10-PCS code sets, with final decisions on code revisions made by the Department of Health and Human Services (HHS)

  • Updates are released bi-annually, on April 1 and October 1

📎 ICD-10-PCS Updates and Information

📎 ICD-10-PCS Official Guidelines for Coding and Reporting

Code Structure​

Each ICD-10-PCS code:

  • Is alphanumeric and always 7 characters long
  • Each character position represents a specific axis of classification:
    1. Section (e.g., Medical and Surgical)
    2. Body System (e.g., Heart and Great Vessels)
    3. Root Operation (e.g., Bypass, Resection)
    4. Body Part
    5. Approach
    6. Device
    7. Qualifier

📎 ICD-10-PCS Web-Based Training

Example:​

027034Z
→ Dilation of coronary artery, one artery, with drug-eluting intraluminal device, percutaneous approach

Key Use Cases for ICD-10-PCS Codes​

  • Inpatient Billing & Reimbursement: Required for hospital claims submitted to Medicare and most commercial payers
  • DRG Assignment: Used to group hospital stays into MS-DRGs for payment
  • Utilization & Quality Analysis: Helps track surgical procedures and outcomes
  • Clinical Research: Enables studies based on coded interventions

📌 Notes for Data Analysts

  • ICD-10-PCS codes are always 7 characters and should not contain periods
  • Hierarchical classification often requires using the Section, Root Operation, and Body System positions

Tuva Seed File Update Process​

Note: This is the maintenance process used by Tuva to maintain the current codeset in the Tuva package. Tuva users do not need to complete this step unless they are leveraging a different version of codes or are no longer updating to the current version of the project, but need an updated terminology set.

  1. Navigate to the CMS ICD 10 website
  2. Go to the ICD-10 Files section, click the section for ICD-10-CM & PCS files of the current fiscal year (e.g. 2025 ICD-10 CM & PCS)
  3. After that go to the ICD-10-PCS files section, and click the hyperlink for "ICD-10-PCS Codes File"
  4. Unzip the downloaded file and open “icd10pcs_codes_{year}”
  5. Save the "icd10pcs_codes_{year}" as a text file
  6. Load the text file into the below python script:

Since the text file contains fixed-length fields, the following Python script can be used to convert it into a CSV file.

import pandas as pd

#This function converts the text file into a dataframe with single field 'Text'
def text_to_dataframe(input_file):
    with open(input_file, 'r', encoding='utf-8') as file:
        lines = file.readlines()
    df = pd.DataFrame({'Text': lines})
    df['Text'] = df['Text'].str.strip('\n')
    return df

def main():
    input_filename = "your text file path"
    output_filename = "output csv file path"     
    
    df = text_to_dataframe(input_filename)

    #Slices the single column dataframe into dataframe with required columns
    df['icd_10_pcs'] = df['Text'].str.slice(0,7)
    df['description'] = df['Text'].str.slice(7,)
    print(df[['icd_10_pcs','description']].head())

    df2 = df[['icd_10_pcs','description']]
    # Remove leading/trailing whitespace from all string columns
    df2 = df2.apply(lambda x: x.str.strip() if x.dtype == "object" else x)
    
    df2.to_csv(output_filename, index=False)

if __name__ == "__main__":
    main()

Note: You might need to adjust the slicing indexes according to the length of your data field

  1. Import the CSV file into any data warehouse and upload the CSV file from the data warehouse to S3 (credentials with write permissions to the S3 bucket are required)
-- example code for Snowflake
copy into s3://tuva-public-resources/terminology/icd_10_pcs.csv
from [table_created_in_step_6]
file_format = (type = csv field_optionally_enclosed_by = '"')
storage_integration = [integration_with_s3_write_permissions]
OVERWRITE = TRUE;
  1. Create a branch in docs. Update the last_updated column in the table above with the current date
  2. Submit a pull request

The below steps are only required if the headers of the file need to be changed. The Tuva Project does not store the contents of the ICD-10-PCS file in GitHub.

  1. Create a branch in The Tuva Project
  2. Alter the headers as needed in ICD-10-PCS file
  3. Submit a pull request